King, Dee Dee

King, Dee Dee is an sole proprietor health care provider with primary practice located at 340 Hwy 138 , Crestline CA 92325-6300. She recently has 2 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder), Other Service Providers / Case Manager/Care Coordinator. Other Service Providers / Case Manager/Care Coordinator is her primary health care specialty. King, Dee Dee can be contacted via phone (909) 336-3330.

Contact Information

Primary practice address
340 Hwy 138 Crestline CA 92325-6300
Phone: (909) 336-3330
Fax: (951) 300-4719
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder) 101YA0400X
Other Service Providers / Case Manager/Care Coordinator 171M00000X

Profile Details

NPI number 1881913051
LBN Legal business name King, Dee Dee
Credentials
Entity Individual
Sole proprietor 1 Yes
Enumeration date May 26th, 2010
Last updated Dec 15th, 2020 - about 4 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

Request for update

Identifiers

StateTypeNumberIssuer
All States NPI 1881913051 NPPES
California MEDICAID CMM70956F
California MEDICAID 196856000

Popular Providers