Provider Demographics
NPI:1093201675
Name:KING, ALEXANDRIA (PSYD)
Entity type:Individual
Prefix:DR
First Name:ALEXANDRIA
Middle Name:
Last Name:KING
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:GENERAL DELIVERY
Mailing Address - Street 2:
Mailing Address - City:KEAAU
Mailing Address - State:HI
Mailing Address - Zip Code:96749-9999
Mailing Address - Country:US
Mailing Address - Phone:860-680-0176
Mailing Address - Fax:
Practice Address - Street 1:16-2103 UAU RD
Practice Address - Street 2:
Practice Address - City:KURTISTOWN
Practice Address - State:HI
Practice Address - Zip Code:96749
Practice Address - Country:US
Practice Address - Phone:860-680-0176
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-07-06
Last Update Date:2023-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIPSY-2063103TC0700X, 103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical