Healthcare Provider Details

I. General information

NPI: 1932756228
Provider Name (Legal Business Name): NIA KING LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/21/2019
Last Update Date: 08/03/2026
Certification Date: 08/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

14534 LEFLOSS AVE
NORWALK CA
90650-4605
US

IV. Provider business mailing address

14534 LEFLOSS AVE
NORWALK CA
90650-4605
US

V. Phone/Fax

Practice location:
  • Phone: 562-253-1420
  • Fax:
Mailing address:
  • Phone: 562-253-1420
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number110932
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: