Individual
KATHLYN LEE MANKAU
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
995 GATEWAY CENTER WAY, SAN DIEGO, CA 92102-4500
(619) 275-0822
Mailing address
1055 E COLORADO BLVD STE 560, PASADENA, CA 91106-2380
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
11057
CA
101YM0800X
Mental Health Counselor
APCC11057
CA
101YM0800X
Mental Health Counselor
—
—
101YP2500X
Professional Counselor
Primary
APCC11057
CA
106S00000X
Behavior Technician
—
—
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
12/03/2019
Last updated
10/11/2024
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