Healthcare Provider Details

I. General information

NPI: 1629446018
Provider Name (Legal Business Name): MAGGIE KING
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/02/2015
Last Update Date: 10/28/2025
Certification Date: 10/28/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

667 LIGHTHOUSE AVE STE 201
PACIFIC GROVE CA
93950-2666
US

IV. Provider business mailing address

667 LIGHTHOUSE AVE STE 201
PACIFIC GROVE CA
93950-2666
US

V. Phone/Fax

Practice location:
  • Phone: 626-230-2363
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number18375
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number183556
License Number State
# 3
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: