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General NPI Number Information
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NPI Number | 1568593747
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Entity Type | Individual
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Provider Name | KATHLEEN COOK PH.D.
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Gender | Female
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Dates
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Enumeration Date | 03/08/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 111 N LA BREA AVE SUITE 700
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City | INGLEWOOD
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State | CA
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Zip | 90301-1752
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Country | US
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Telephone | 310-677-7808
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Fax |
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Provider Business Mailing Address
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Address Line | 12543 PRESTON WAY
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City | LOS ANGELES
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State | CA
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Zip | 90066-1823
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Country | US
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Telephone |
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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 | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | PSY18168
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License Number State | CA
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