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General NPI Number Information
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NPI Number | 1265503908
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Entity Type | Individual
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Provider Name | KATHLEEN M. MCKENNA M.D.
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Gender | Female
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Dates
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Enumeration Date | 11/13/2006
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Last Update Date | 04/12/2024
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Provider Practice Location Address
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Address Line | 1000 W CARSON ST
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City | TORRANCE
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State | CA
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Zip | 90502-2004
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Country | US
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Telephone | 773-880-4000
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Fax |
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Provider Business Mailing Address
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Address Line | 5310 HALISON ST
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City | TORRANCE
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State | CA
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Zip | 90503-1212
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Country | US
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Telephone | 131-084-8416
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084P0804X
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Taxonomy Name | Child & Adolescent Psychiatry Physician
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License Number | C52643
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License Number State | CA
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