| Doctor Name: | COLLETTE LEE KING |
| NPI Number: | 1194857656 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | FNP |
| License Number: | 10843 |
| Business Practice Address: | 29525 Canwood St Suite 300 Agoura Hills, CA - 913014233 |
| Business Phone Number: | 8187062477 |
| Business Fax Number: | 8187062368 |
| Mailing Address: | 29525 Canwood St, Suite 300 AGOURA HILLS |
| State: | CA |
| Postal Code: | 913014233 |
| Phone Number: | 8187062477 |
| Fax Number: | |
| NPI Enumeration Date: | 03/11/2007 |
| NPI Last Update Date: | 02/12/2013 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LF0000X |
| License Number: | 10843 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | CA |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Family |
| Taxonomy Definition: | |