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General NPI Number Information
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NPI Number | 1902966005
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Entity Type | Individual
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Provider Name | JACQUELINE KAY SORENSON-MCDANIEL M.A., LMFT
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Gender | Female
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Dates
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Enumeration Date | 12/11/2006
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Last Update Date | 11/13/2012
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Provider Practice Location Address
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Address Line | 4525 E ATHERTON ST 2ND FLOOR
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City | LONG BEACH
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State | CA
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Zip | 90815-3700
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Country | US
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Telephone | 562-422-2240
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Fax | 562-423-1816
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Provider Business Mailing Address
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Address Line | 2909 LOOMIS STREET
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City | LAKEWOOD
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State | CA
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Zip | 90712-3318
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Country | US
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Telephone | 562-422-2240
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Fax | 562-423-1816
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | MFC32999
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License Number State | CA
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