Provider Demographics
NPI:1003779059
Name:DORSEY, KATRINA RENEE
Entity type:Individual
Prefix:
First Name:KATRINA
Middle Name:RENEE
Last Name:DORSEY
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 1:19124 RADLETT AVE
Mailing Address - Street 2:
Mailing Address - City:CARSON
Mailing Address - State:CA
Mailing Address - Zip Code:90746-2682
Mailing Address - Country:US
Mailing Address - Phone:323-552-4814
Mailing Address - Fax:
Practice Address - Street 1:444 W OCEAN BLVD STE 800
Practice Address - Street 2:
Practice Address - City:LONG BEACH
Practice Address - State:CA
Practice Address - Zip Code:90802-4529
Practice Address - Country:US
Practice Address - Phone:562-682-1047
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-12-06
Last Update Date:2025-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAASW1316941041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical