Healthcare Provider Details

I. General information

NPI: 1285558197
Provider Name (Legal Business Name): KATE MCKENNA AMFT, MT-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/05/2026
Last Update Date: 08/05/2026
Certification Date: 08/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1212 N VERMONT AVE
LOS ANGELES CA
90029-1769
US

IV. Provider business mailing address

4545 1/2 PICKFORD ST
LOS ANGELES CA
90019-5818
US

V. Phone/Fax

Practice location:
  • Phone: 323-443-3225
  • Fax:
Mailing address:
  • Phone: 774-313-6099
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code225A00000X
TaxonomyMusic Therapist
License Number17270
License Number State
# 2
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number162982
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: