Provider Demographics
NPI:1538414768
Name:STOKMAN, RENEE FLOURNOY (LMFT)
Entity type:Individual
Prefix:
First Name:RENEE
Middle Name:FLOURNOY
Last Name:STOKMAN
Suffix:
Gender:F
Credentials:LMFT
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 7152
Mailing Address - Street 2:
Mailing Address - City:FULLERTON
Mailing Address - State:CA
Mailing Address - Zip Code:92834-7152
Mailing Address - Country:US
Mailing Address - Phone:714-446-8836
Mailing Address - Fax:
Practice Address - Street 1:7100 KNOTT AVE
Practice Address - Street 2:
Practice Address - City:BUENA PARK
Practice Address - State:CA
Practice Address - Zip Code:90620-1314
Practice Address - Country:US
Practice Address - Phone:714-562-0406
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-07-13
Last Update Date:2012-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA51608106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist