Provider Demographics
NPI:1508008483
Name:KING, BETH J (MS - COUN PSYCH)
Entity Type:Individual
Prefix:
First Name:BETH
Middle Name:J
Last Name:KING
Suffix:
Gender:F
Credentials:MS - COUN PSYCH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1908 BUSINESS CENTER DR
Mailing Address - Street 2:STE. 220
Mailing Address - City:SAN BERNARDINO
Mailing Address - State:CA
Mailing Address - Zip Code:92408-3436
Mailing Address - Country:US
Mailing Address - Phone:909-385-2517
Mailing Address - Fax:909-890-5950
Practice Address - Street 1:1908 BUSINESS CENTER DR
Practice Address - Street 2:STE. 220
Practice Address - City:SAN BERNARDINO
Practice Address - State:CA
Practice Address - Zip Code:92408-3436
Practice Address - Country:US
Practice Address - Phone:909-385-2517
Practice Address - Fax:909-890-5950
Is Sole Proprietor?:No
Enumeration Date:2009-03-24
Last Update Date:2010-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor