Healthcare Provider Details

I. General information

NPI: 1528972395
Provider Name (Legal Business Name): DURALD AUDRE MCKEE ACSW
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/29/2026
Last Update Date: 09/29/2026
Certification Date: 09/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

514 W PACIFIC COAST HWY
LONG BEACH CA
90806-5237
US

IV. Provider business mailing address

241 W 220TH ST APT A
CARSON CA
90745-2965
US

V. Phone/Fax

Practice location:
  • Phone: 562-432-0713
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License NumberASW136592
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: