Provider Demographics
NPI:1972142453
Name:KING, MARILEE JAMES (MFT)
Entity Type:Individual
Prefix:
First Name:MARILEE
Middle Name:JAMES
Last Name:KING
Suffix:
Gender:F
Credentials:MFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5127 SADDLE BROOK DR
Mailing Address - Street 2:
Mailing Address - City:OAKLAND
Mailing Address - State:CA
Mailing Address - Zip Code:94619-3517
Mailing Address - Country:US
Mailing Address - Phone:510-530-0111
Mailing Address - Fax:
Practice Address - Street 1:5127 SADDLE BROOK DR
Practice Address - Street 2:
Practice Address - City:OAKLAND
Practice Address - State:CA
Practice Address - Zip Code:94619-3517
Practice Address - Country:US
Practice Address - Phone:510-530-0111
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-12-31
Last Update Date:2019-12-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist