Healthcare Provider Details

I. General information

NPI: 1255053807
Provider Name (Legal Business Name): MRS. KATHRYN DUNCAN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/12/2022
Last Update Date: 05/26/2026
Certification Date: 05/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1101 N SEPULVEDA BLVD STE 202
MANHATTAN BEACH CA
90266-5963
US

IV. Provider business mailing address

1101 N SEPULVEDA BLVD STE 202
MANHATTAN BEACH CA
90266-5963
US

V. Phone/Fax

Practice location:
  • Phone: 747-277-4579
  • Fax:
Mailing address:
  • Phone: 747-277-4579
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number155644
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: