Active NPI
Catherine Anne Leake, PH.D.
- Psychologist
- Redondo Beach, CA
National Provider Identifier
1558062364
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychologist
- License
- 18017
- Practice address
- 1917 S Catalina Ave Ste 2
Redondo Beach, CA 90277-5515 - Phone
- (310) 378-4896
- NPI assigned
- Mar 17, 2023
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychologist | 103T00000X | 18017 | CA | Primary |
Addresses
Primary practice location
1917 S Catalina Ave Ste 2
Redondo Beach, CA 90277-5515
Mailing address
5632 Scotwood Dr
Rancho Palos Verdes, CA 90275-4915
Phone (310) 938-4456
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Opted out of Medicare
- Yes, effective Feb 19, 2023 through Feb 19, 2027
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 18017 | CA | MD | Dental Hygienist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1679011200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1679011200000",
"number": "1558062364",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5632 SCOTWOOD DR",
"city": "RANCHO PALOS VERDES",
"state": "CA",
"postal_code": "902754915",
"telephone_number": "310-938-4456"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1917 S CATALINA AVE STE 2",
"city": "REDONDO BEACH",
"state": "CA",
"postal_code": "902775515",
"telephone_number": "310-378-4896"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LEAKE",
"first_name": "CATHERINE",
"middle_name": "ANNE",
"name_prefix": "Dr.",
"credential": "PH.D.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2023-03-17",
"last_updated": "2023-03-17",
"certification_date": "2023-03-17",
"status": "A"
},
"taxonomies": [
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "CA",
"license": "18017",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Redondo Beach, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.