Provider Demographics
NPI:1427298447
Name:KING, RICHARD M (MFT)
Entity type:Individual
Prefix:MR
First Name:RICHARD
Middle Name:M
Last Name:KING
Suffix:
Gender:M
Credentials:MFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 7999
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94120-7999
Mailing Address - Country:US
Mailing Address - Phone:415-600-2683
Mailing Address - Fax:415-749-1433
Practice Address - Street 1:1625 VAN NESS AVE FL 3
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94109-3608
Practice Address - Country:US
Practice Address - Phone:415-600-6200
Practice Address - Fax:415-749-1433
Is Sole Proprietor?:No
Enumeration Date:2009-03-03
Last Update Date:2009-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFT41112106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist