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Provider Information for 1548445851


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Mr. PAUL RAYMOND BOOTH LMFT


Sex: Male

NPI: 1548445851
Last Updated: 2017-03-28
Certification Date:

Details

NameValue
NPI1548445851
Enumeration Date2008-01-04
NPI TypeNPI-1 Individual
Sole ProprietorYES
StatusActive
Mailing Address 119 FIGUEROA ST
VENTURA, CA 93001-2756
United States

Phone: 805-642-6779 | Fax:
 
Primary Practice Address 119 FIGUEROA ST
VENTURA, CA 93001-2756
United States

Phone: 805-642-6779 | Fax:
 
Secondary Practice Address(es)
Health Information Exchange
Endpoint TypeEndpointEndpoint DescriptionUseContent TypeAffiliationEndpoint Location
Other Identifiers
IssuerStateNumberOther Issuer
Taxonomy
Primary TaxonomySelected TaxonomyStateLicense Number
No 101YA0400X - Counselor - Addiction (Substance Use Disorder)
Yes 106H00000X - Marriage & Family Therapist CAMFT35900