Provider Demographics
NPI:1114164373
Name:KING-THOMAS, SIOTHA LEE (OCM)
Entity Type:Individual
Prefix:MS
First Name:SIOTHA
Middle Name:LEE
Last Name:KING-THOMAS
Suffix:
Gender:F
Credentials:OCM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1060 HOWARD ST
Mailing Address - Street 2:3RD FLOOR
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94103-2820
Mailing Address - Country:US
Mailing Address - Phone:415-748-0451
Mailing Address - Fax:415-863-4867
Practice Address - Street 1:1060 HOWARD ST
Practice Address - Street 2:3RD FLOOR
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94103-2820
Practice Address - Country:US
Practice Address - Phone:415-748-0451
Practice Address - Fax:415-863-4867
Is Sole Proprietor?:Yes
Enumeration Date:2009-01-09
Last Update Date:2012-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator