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General NPI Number Information
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NPI Number | 1457478414
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Entity Type | Individual
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Provider Name | KERRI CHASE KING PHD
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Gender | Female
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Dates
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Enumeration Date | 03/23/2007
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Last Update Date | 07/12/2007
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Provider Practice Location Address
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Address Line | 1270 NATIVIDAD RD ROOM 200
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City | SALINAS
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State | CA
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Zip | 93906-3122
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Country | US
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Telephone | 831-755-4300
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Fax |
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Provider Business Mailing Address
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Address Line | 1020 WENTZ DR
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City | GILROY
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State | CA
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Zip | 95020-5920
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Country | US
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Telephone | 408-852-0500
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | 21499
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License Number State | CA
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