Stacey King

Primary specialty

Social WorkerTaxonomy code 104100000X

License

ASW119115 Issued in CA

Practice address

572 N Arrowhead Ave
San Bernardino, CA 92401-1251

Phone

(909) 781-1596

NPI assigned

Jan 19, 2017

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 5

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Olive Crest

  • Mental Illness Community Based Residential Treatment Facility
  • Perris, CA
  • NPI 1285288316
  NPD
• West Covina Foster Family Agency

  dba Sunrise Horizon

  • Emotionally Disturbed Childrens' Residential Treatment Facility
  • Chino, CA
  • NPI 1306394879

  Behavior Analyst

  NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1484784000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1701820800000",
    "number": "1649717323",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "25124 FIR AVE APT 44",
            "city": "MORENO VALLEY",
            "state": "CA",
            "postal_code": "925532307",
            "telephone_number": "951-255-1320"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "572 N ARROWHEAD AVE",
            "city": "SAN BERNARDINO",
            "state": "CA",
            "postal_code": "924011251",
            "telephone_number": "909-781-1596"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "7226 Sepulveda Blvd",
            "address_purpose": "LOCATION",
            "city": "Van Nuys",
            "state": "CA",
            "postal_code": "914052003",
            "country_code": "US",
            "telephone_number": "818-235-1414",
            "fax_number": "818-945-0827",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "23115 Rider St",
            "address_purpose": "LOCATION",
            "city": "Perris",
            "state": "CA",
            "postal_code": "925709723",
            "country_code": "US",
            "telephone_number": "951-686-8500 x4019",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "4041 Carroll Ct",
            "address_purpose": "LOCATION",
            "city": "Chino",
            "state": "CA",
            "postal_code": "917103139",
            "country_code": "US",
            "telephone_number": "909-591-2589",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "650 N State St",
            "address_purpose": "LOCATION",
            "city": "Hemet",
            "state": "CA",
            "postal_code": "925432960",
            "country_code": "US",
            "telephone_number": "951-791-3300",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KING",
        "first_name": "STACEY",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-01-19",
        "last_updated": "2023-12-06",
        "certification_date": "2023-12-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "CA",
            "license": "ASW119115",
            "primary": true
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Beth J King, MS - COUN PSYCH
• Clementine King, PA
• Kai Joseph King
• Maria Angela King, CNM, RN
• Skyler Ryan King, PA
• Agnes B Kintanar, M.D.
• Joshua Obadiah Kirby
• Kennith Dra Kirk
• Summer Victoria Kirkpatrick
• Celesti Kiroyan, PHARMD

• Social Worker in San Bernardino, CA
• Providers in San Bernardino, CA by specialty
• Social Worker in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 6, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.