Healthcare Provider Details

I. General information

NPI: 1093063679
Provider Name (Legal Business Name): FELICIA ANN KING ARYE LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: FELICIA ANN KING LCSW

II. Dates (important events)

Enumeration Date: 08/29/2012
Last Update Date: 08/29/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

50 PHELAN AVENUE CCSF SHC 100
SAN FRANCISCO CA
94112-1821
US

IV. Provider business mailing address

50 PHELAN AVENUE CCSF SHC 100
SAN FRANCISCO CA
94112
US

V. Phone/Fax

Practice location:
  • Phone: 415-239-3110
  • Fax: 415-239-3193
Mailing address:
  • Phone: 415-239-3110
  • Fax: 415-239-3193

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberLCS 19893
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: