Provider Demographics
NPI:1205355104
Name:KING, DENETTE L (PHD)
Entity type:Individual
Prefix:DR
First Name:DENETTE
Middle Name:L
Last Name:KING
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:DR
Other - First Name:DENETTE
Other - Middle Name:LAYVONNE
Other - Last Name:BOYD-KING
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:PHD
Mailing Address - Street 1:1730 E HELMICK ST
Mailing Address - Street 2:
Mailing Address - City:CARSON
Mailing Address - State:CA
Mailing Address - Zip Code:90746-2515
Mailing Address - Country:US
Mailing Address - Phone:310-750-8599
Mailing Address - Fax:
Practice Address - Street 1:14112 S KINGSLEY DR
Practice Address - Street 2:
Practice Address - City:GARDENA
Practice Address - State:CA
Practice Address - Zip Code:90249-3018
Practice Address - Country:US
Practice Address - Phone:310-533-6600
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-09-12
Last Update Date:2023-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225C00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRehabilitation Counselor
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program