Provider Demographics
NPI:1093063679
Name:KING ARYE, FELICIA ANN (LCSW)
Entity Type:Individual
Prefix:
First Name:FELICIA
Middle Name:ANN
Last Name:KING ARYE
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:FELICIA
Other - Middle Name:ANN
Other - Last Name:KING
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LCSW
Mailing Address - Street 1:50 PHELAN AVENUE
Mailing Address - Street 2:CCSF SHC 100
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94112
Mailing Address - Country:US
Mailing Address - Phone:415-239-3110
Mailing Address - Fax:415-239-3193
Practice Address - Street 1:50 PHELAN AVENUE
Practice Address - Street 2:CCSF SHC 100
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94112-1821
Practice Address - Country:US
Practice Address - Phone:415-239-3110
Practice Address - Fax:415-239-3193
Is Sole Proprietor?:No
Enumeration Date:2012-08-29
Last Update Date:2012-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALCS 198931041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical