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General NPI Number Information
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NPI Number | 1558463083
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Entity Type | Individual
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Provider Name | KATHLEEN ANN HERRON M.D.
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Gender | Female
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Dates
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Enumeration Date | 09/04/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 5901 E 7TH ST
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City | LONG BEACH
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State | CA
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Zip | 90822-5201
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Country | US
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Telephone | 562-826-8000
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Fax | 562-826-5580
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Provider Business Mailing Address
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Address Line | 4373 ELDER AVE
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City | SEAL BEACH
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State | CA
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Zip | 90740-2955
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Country | US
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Telephone | 562-430-4291
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Fax | 775-248-8925
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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 | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | C51455
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | 151969-1
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License Number State | NY
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Taxonomy #3
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | 0101056534
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License Number State | VA
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