Provider Demographics
NPI:1568587806
Name:SORENSEN, STANLEY PAUL (MFT)
Entity Type:Individual
Prefix:MR
First Name:STANLEY
Middle Name:PAUL
Last Name:SORENSEN
Suffix:
Gender:M
Credentials:MFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:44758 ELM AVE
Mailing Address - Street 2:
Mailing Address - City:LANCASTER
Mailing Address - State:CA
Mailing Address - Zip Code:93534-3105
Mailing Address - Country:US
Mailing Address - Phone:661-948-8559
Mailing Address - Fax:661-942-0738
Practice Address - Street 1:44758 ELM AVE
Practice Address - Street 2:
Practice Address - City:LANCASTER
Practice Address - State:CA
Practice Address - Zip Code:93534-3105
Practice Address - Country:US
Practice Address - Phone:661-948-8559
Practice Address - Fax:661-942-0738
Is Sole Proprietor?:No
Enumeration Date:2007-03-19
Last Update Date:2011-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFC30482106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist