Healthcare Provider Details

I. General information

NPI: 1184560203
Provider Name (Legal Business Name): MORRAKOT KING
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/29/2026
Last Update Date: 04/29/2026
Certification Date: 04/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

25 MEADOW AVE
SAN RAFAEL CA
94901-5231
US

IV. Provider business mailing address

369B 3RD ST # 174
SAN RAFAEL CA
94901-3581
US

V. Phone/Fax

Practice location:
  • Phone: 415-302-8508
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number153707
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: