Active NPI
Letrilla C King, ED.D.
- Counseling Psychologist
- San Diego, CA
National Provider Identifier
1245691997
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Counseling Psychologist
- License
- 31495
- Practice address
- 1501 5TH Ave. Ste. 100
San Diego, CA 92101 - Phone
- (619) 865-0988
- Fax
- (619) 456-0988
- NPI assigned
- Mar 9, 2016
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Addiction (Substance Use Disorder) Counselor | 101YA0400X | |||
| Counseling Psychologist | 103TC1900X | 31495 | CA | Primary |
Addresses
Primary practice location
1501 5TH Ave. Ste. 100
San Diego, CA 92101
Mailing address
1501 5TH Ave. Ste. 100
San Diego, CA 92101
Phone (619) 865-0988
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 31495 | CA | MD | Marriage & Family Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1457481600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1575849600000",
"number": "1245691997",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1501 5TH AVE. STE. 100",
"city": "SAN DIEGO",
"state": "CA",
"postal_code": "92101",
"telephone_number": "619-865-0988",
"fax_number": "619-456-0988"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1501 5TH AVE. STE. 100",
"city": "SAN DIEGO",
"state": "CA",
"postal_code": "92101",
"telephone_number": "619-865-0988",
"fax_number": "619-456-0988"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KING",
"first_name": "LETRILLA",
"middle_name": "C",
"credential": "ED.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2016-03-09",
"last_updated": "2019-12-09",
"certification_date": "2019-12-09",
"status": "A"
},
"taxonomies": [
{
"code": "101YA0400X",
"taxonomy_group": "",
"desc": "Counselor, Addiction (Substance Use Disorder)",
"state": null,
"license": null,
"primary": false
},
{
"code": "103TC1900X",
"taxonomy_group": "",
"desc": "Psychologist, Counseling",
"state": "CA",
"license": "31495",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in San Diego, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 9, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.