Provider Demographics
NPI:1669634945
Name:SORENSEN, KAREN L (PHD)
Entity Type:Individual
Prefix:MS
First Name:KAREN
Middle Name:L
Last Name:SORENSEN
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:KAREN
Other - Middle Name:L
Other - Last Name:SORENSEN
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:PHD A PROFESSIONAL P
Mailing Address - Street 1:1804 GARNET AVE # 196
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92109-3352
Mailing Address - Country:US
Mailing Address - Phone:858-395-7121
Mailing Address - Fax:858-256-9308
Practice Address - Street 1:5252 BALBOA AVE.
Practice Address - Street 2:STE. 803
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92117-6920
Practice Address - Country:US
Practice Address - Phone:858-395-7121
Practice Address - Fax:858-256-9308
Is Sole Proprietor?:No
Enumeration Date:2008-06-27
Last Update Date:2021-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY23540103T00000X, 103TC0700X
CAPSB22066103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
No103T00000XBehavioral Health & Social Service ProvidersPsychologist