Healthcare Provider Details

I. General information

NPI: 1013313840
Provider Name (Legal Business Name): KATHARINE ALLEY LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/05/2014
Last Update Date: 08/17/2026
Certification Date: 08/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3112 OAK AVE
MANHATTAN BEACH CA
90266-2440
US

IV. Provider business mailing address

3112 OAK AVE
MANHATTAN BEACH CA
90266-2440
US

V. Phone/Fax

Practice location:
  • Phone: 626-884-6664
  • Fax:
Mailing address:
  • Phone: 626-884-6664
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number84926
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberL18596
License Number StateOR
# 3
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberCSW.09929394
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: