| Doctor Name: | DR. KATHLEEN ELDRIDGE |
| NPI Number: | 1255547667 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | PHD |
| License Number: | PSY 19447 |
| Business Practice Address: | 24255 Pacific Coast Hwy Malibu, CA - 902633999 |
| Business Phone Number: | 3105068559 |
| Business Fax Number: | |
| Mailing Address: | 24255 Pacific Coast Hwy, MALIBU |
| State: | CA |
| Postal Code: | 902633999 |
| Phone Number: | |
| Fax Number: | |
| NPI Enumeration Date: | 05/15/2007 |
| NPI Last Update Date: | 07/08/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 103TC0700X |
| License Number: | PSY 19447 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | CA |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Psychologist |
| Taxonomy Specialization: | Clinical |
| Taxonomy Definition: | |