Provider Demographics
NPI:1326930447
Name:GORMAN, JEAN CHENG (PSYD)
Entity type:Individual
Prefix:
First Name:JEAN
Middle Name:CHENG
Last Name:GORMAN
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:680 LIGHTHOUSE AVE UNIT 52055
Mailing Address - Street 2:
Mailing Address - City:PACIFIC GROVE
Mailing Address - State:CA
Mailing Address - Zip Code:93950-8097
Mailing Address - Country:US
Mailing Address - Phone:831-293-9005
Mailing Address - Fax:
Practice Address - Street 1:680 LIGHTHOUSE AVE UNIT 52055
Practice Address - Street 2:
Practice Address - City:PACIFIC GROVE
Practice Address - State:CA
Practice Address - Zip Code:93950-8097
Practice Address - Country:US
Practice Address - Phone:831-293-9005
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-07-15
Last Update Date:2025-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY26984103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist