Provider Demographics
NPI:1033983135
Name:LORENZO, SHERRY ANNE GELLE (LMFT)
Entity Type:Individual
Prefix:
First Name:SHERRY ANNE
Middle Name:GELLE
Last Name:LORENZO
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 45803
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92145-0803
Mailing Address - Country:US
Mailing Address - Phone:858-232-9430
Mailing Address - Fax:
Practice Address - Street 1:230 N MAR VISTA AVE
Practice Address - Street 2:
Practice Address - City:PASADENA
Practice Address - State:CA
Practice Address - Zip Code:91106-1411
Practice Address - Country:US
Practice Address - Phone:510-255-0965
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-11-09
Last Update Date:2023-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA53589106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist