Provider Demographics
NPI:1053015487
Name:O'DOWD, KATHRINE (PHD)
Entity type:Individual
Prefix:
First Name:KATHRINE
Middle Name:
Last Name:O'DOWD
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:21313 HAWTHORNE BLVD.
Mailing Address - Street 2:SUITE B, #1038
Mailing Address - City:TORRANCE
Mailing Address - State:CA
Mailing Address - Zip Code:90503-6141
Mailing Address - Country:US
Mailing Address - Phone:310-853-2557
Mailing Address - Fax:424-201-1601
Practice Address - Street 1:2601 AIRPORT DR STE 135
Practice Address - Street 2:
Practice Address - City:TORRANCE
Practice Address - State:CA
Practice Address - Zip Code:90505-6141
Practice Address - Country:US
Practice Address - Phone:424-201-1600
Practice Address - Fax:424-201-1601
Is Sole Proprietor?:Yes
Enumeration Date:2023-03-29
Last Update Date:2024-11-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY35468103T00000X
CAPSB94027330390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAPSB94027330OtherLICENSE #