Individual
KATHRYN CUMMINS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2403 S MORAY AVE, SAN PEDRO, CA 90732-4342
(424) 488-9973
Mailing address
2403 S MORAY AVE, SAN PEDRO, CA 90732-4342
(424) 488-9973
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
PSY27282
CA
101YM0800X
Mental Health Counselor
PSY27282
CA
101YP2500X
Professional Counselor
PSY27282
CA
103G00000X
Clinical Neuropsychologist
Primary
PSY27282
CA
Other
Enumeration date
12/10/2012
Last updated
06/05/2015
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