Provider Demographics
NPI:1457156994
Name:WALKER, KACEY (AMFT)
Entity type:Individual
Prefix:MRS
First Name:KACEY
Middle Name:
Last Name:WALKER
Suffix:
Gender:
Credentials:AMFT
Other - Prefix:
Other - First Name:KACEY
Other - Middle Name:
Other - Last Name:MATTHES
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:407 N PACIFIC COAST HWY # 319
Mailing Address - Street 2:
Mailing Address - City:REDONDO BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:90277-2872
Mailing Address - Country:US
Mailing Address - Phone:424-468-8900
Mailing Address - Fax:
Practice Address - Street 1:2309 PACIFIC COAST HWY STE 207
Practice Address - Street 2:
Practice Address - City:HERMOSA BEACH
Practice Address - State:CA
Practice Address - Zip Code:90254-2753
Practice Address - Country:US
Practice Address - Phone:424-468-8900
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-02-18
Last Update Date:2025-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist