Provider Demographics
NPI:1942328950
Name:CRONIN, KATHRYN
Entity Type:Individual
Prefix:
First Name:KATHRYN
Middle Name:
Last Name:CRONIN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:410 CAMINO REAL
Mailing Address - Street 2:
Mailing Address - City:REDONDO BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:90277-3815
Mailing Address - Country:US
Mailing Address - Phone:310-316-1212
Mailing Address - Fax:310-316-4411
Practice Address - Street 1:1617 CRAVENS AVE
Practice Address - Street 2:
Practice Address - City:TORRANCE
Practice Address - State:CA
Practice Address - Zip Code:90501-3203
Practice Address - Country:US
Practice Address - Phone:310-328-0855
Practice Address - Fax:310-328-9636
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-27
Last Update Date:2007-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker