Provider Demographics
NPI:1235014143
Name:JENSEN, KIRSTEN LEI (PPS CRED 150094777)
Entity type:Individual
Prefix:DR
First Name:KIRSTEN
Middle Name:LEI
Last Name:JENSEN
Suffix:
Gender:F
Credentials:PPS CRED 150094777
Other - Prefix:MRS
Other - First Name:KIRSTEN
Other - Middle Name:LEI
Other - Last Name:JENSEN-SANDBLOOM
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PPS SCHOOL COUNSELIN
Mailing Address - Street 1:10293 BLOOMFIELD ST
Mailing Address - Street 2:
Mailing Address - City:LOS ALAMITOS
Mailing Address - State:CA
Mailing Address - Zip Code:90720-2264
Mailing Address - Country:US
Mailing Address - Phone:562-799-4740
Mailing Address - Fax:562-799-4773
Practice Address - Street 1:10821 OAK ST
Practice Address - Street 2:
Practice Address - City:LOS ALAMITOS
Practice Address - State:CA
Practice Address - Zip Code:90720-2313
Practice Address - Country:US
Practice Address - Phone:562-799-4740
Practice Address - Fax:562-799-4773
Is Sole Proprietor?:No
Enumeration Date:2025-08-08
Last Update Date:2025-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA1500094777101YS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YS0200XBehavioral Health & Social Service ProvidersCounselorSchool