Individual provider Active NPI

Kathleen Condry Harley, N.D.

  • Naturopath
  • Novato, CA
National Provider Identifier
1962788034
Registry record updated Feb 12, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
NaturopathTaxonomy code 175F00000X
License
ND-481 Issued in CA
Practice address
250 Bel Marin Keys Blvd Ste D2
Novato, CA 94949-5709
Phone
(415) 721-7453
Fax
(415) 721-7454
NPI assigned
Nov 2, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 12, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X ND-481 CA
Prevention Professional 405300000X ND-481 CA
Naturopath 175F00000X ND-481 CA Primary

Addresses

Primary practice location

250 Bel Marin Keys Blvd Ste D2
Novato, CA 94949-5709

Mailing address

8669 Salmon Ave Unit 2705
Kings Beach, CA 96143-8108
Phone (415) 721-7453

Other practice location 1

205 Stateline Rd
Kings Beach, CA 96143
Phone (415) 721-7745

Other names 1

  • Dr. Kathleen Condry Harley Professional name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
ND-481CAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Alexander Wulff Past Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1320192000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1739318400000",
    "number": "1962788034",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8669 SALMON AVE UNIT 2705",
            "city": "KINGS BEACH",
            "state": "CA",
            "postal_code": "961438108",
            "telephone_number": "415-721-7453",
            "fax_number": "415-721-7454"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "250 BEL MARIN KEYS BLVD STE D2",
            "city": "NOVATO",
            "state": "CA",
            "postal_code": "949495709",
            "telephone_number": "415-721-7453",
            "fax_number": "415-721-7454"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "205 Stateline Rd",
            "address_purpose": "LOCATION",
            "city": "Kings Beach",
            "state": "CA",
            "postal_code": "96143",
            "country_code": "US",
            "telephone_number": "415-721-7745",
            "fax_number": "415-721-7454",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HARLEY",
        "first_name": "KATHLEEN",
        "middle_name": "CONDRY",
        "name_prefix": "Dr.",
        "credential": "N.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-11-02",
        "last_updated": "2025-02-12",
        "certification_date": "2025-02-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "ND-481",
            "primary": false
        },
        {
            "code": "405300000X",
            "taxonomy_group": "",
            "desc": "Prevention Professional",
            "state": "CA",
            "license": "ND-481",
            "primary": false
        },
        {
            "code": "175F00000X",
            "taxonomy_group": "",
            "desc": "Naturopath",
            "state": "CA",
            "license": "ND-481",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KATHLEEN",
            "last_name": "HARLEY",
            "middle_name": "CONDRY",
            "prefix": "DR.",
            "credential": "ND",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

Other providers in Novato, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 12, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.