Healthcare Provider Details

I. General information

NPI: 1669320966
Provider Name (Legal Business Name): JENNIFER SOEDA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/20/2026
Last Update Date: 03/20/2026
Certification Date: 03/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

340 N MAIN ST
ORANGE CA
92868-2408
US

IV. Provider business mailing address

340 N MAIN ST
ORANGE CA
92868-2408
US

V. Phone/Fax

Practice location:
  • Phone: 714-997-6277
  • Fax:
Mailing address:
  • Phone: 714-997-6277
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TS0200X
TaxonomySchool Psychologist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: