Provider Demographics
NPI:1407370547
Name:SORENSON, ASHLEIGH MARIE (LMFT)
Entity Type:Individual
Prefix:MS
First Name:ASHLEIGH
Middle Name:MARIE
Last Name:SORENSON
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 1:1235 N HARBOR BLVD STE 290
Mailing Address - Street 2:
Mailing Address - City:FULLERTON
Mailing Address - State:CA
Mailing Address - Zip Code:92832-1353
Mailing Address - Country:US
Mailing Address - Phone:714-345-5354
Mailing Address - Fax:
Practice Address - Street 1:1235 N HARBOR BLVD STE 290
Practice Address - Street 2:
Practice Address - City:FULLERTON
Practice Address - State:CA
Practice Address - Zip Code:92832-1353
Practice Address - Country:US
Practice Address - Phone:714-345-5354
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-07-31
Last Update Date:2019-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
88863101YM0800X
CA88863106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty