Healthcare Provider Details

I. General information

NPI: 1891623674
Provider Name (Legal Business Name): WILLIAM JAY KING MA
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/12/2026
Last Update Date: 05/12/2026
Certification Date: 05/12/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

505 S VILLA REAL STE 117
ANAHEIM CA
92807-3441
US

IV. Provider business mailing address

6552 PEGGY CIR
HUNTINGTON BEACH CA
92647-4310
US

V. Phone/Fax

Practice location:
  • Phone: 949-525-5357
  • Fax:
Mailing address:
  • Phone: 949-525-5357
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number147528
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: