Boothe, Krystal Marie
Boothe, Krystal Marie is an sole proprietor health care provider with primary practice located at 1050 Lakes Dr , West Covina CA 91790-2924. She recently has only one registered license in Behavioral Health & Social Service Providers / Clinical, which is considered as her primary health care specialty. Boothe, Krystal Marie can be contacted via phone (310) 621-0150.Contact Information
Primary practice address
1050 Lakes Dr
West Covina CA 91790-2924
Phone: (310) 621-0150
Fax: (661) 727-0006
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Clinical | 1041C0700X | LCSW71811 | California |
Profile Details
| NPI number | 1043488414 |
|---|---|
| LBN Legal business name | Boothe, Krystal Marie |
| Credentials | Licensed Clinical Social Worker (LCSW) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Feb 19th, 2008 |
| Last updated | Feb 25th, 2020 - about 5 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1043488414 | NPPES |
| California | MEDICAID | 99999999999999 | |
| California | Other | 9999999999 |
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