Provider Demographics
NPI:1760637474
Name:MCDERMOTT, KATHLEEN MARY (DNP, PMHNP-BC)
Entity type:Individual
Prefix:MS
First Name:KATHLEEN
Middle Name:MARY
Last Name:MCDERMOTT
Suffix:
Gender:F
Credentials:DNP, PMHNP-BC
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:1611 S PACIFIC COAST HWY STE 307
Mailing Address - Street 2:
Mailing Address - City:REDONDO BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:90277-5614
Mailing Address - Country:US
Mailing Address - Phone:310-818-1902
Mailing Address - Fax:844-888-0583
Practice Address - Street 1:1611 S PACIFIC COAST HWY STE 307
Practice Address - Street 2:
Practice Address - City:REDONDO BEACH
Practice Address - State:CA
Practice Address - Zip Code:90277-5614
Practice Address - Country:US
Practice Address - Phone:310-818-1902
Practice Address - Fax:844-888-0583
Is Sole Proprietor?:Yes
Enumeration Date:2008-11-21
Last Update Date:2024-08-16
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CA16495363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health