Provider Demographics
NPI:1861723157
Name:ZORN, KATHY LOUISE
Entity type:Individual
Prefix:MRS
First Name:KATHY
Middle Name:LOUISE
Last Name:ZORN
Suffix:
Gender:F
Credentials:
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 8063
Mailing Address - Street 2:
Mailing Address - City:LONG BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:90808-0063
Mailing Address - Country:US
Mailing Address - Phone:562-755-9156
Mailing Address - Fax:
Practice Address - Street 1:4401 ATLANTIC AVE.
Practice Address - Street 2:ALLIANCE PSYCHOLOGY GROUP
Practice Address - City:LONG BEACH
Practice Address - State:CA
Practice Address - Zip Code:90807
Practice Address - Country:US
Practice Address - Phone:562-428-3266
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-01-26
Last Update Date:2013-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA47126106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist