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General NPI Number Information
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NPI Number | 1275485369
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Entity Type | Organization
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Legal Business Name | KASSANDRA BOORTZ, LMFT, LLC
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Dates
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Enumeration Date | 02/11/2026
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Last Update Date | 02/11/2026
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Provider Practice Location Address
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Address Line | 881 PRIMROSE LN
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City | NIPOMO
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State | CA
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Zip | 93444-5410
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Country | US
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Telephone | 805-888-0912
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Fax |
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Provider Business Mailing Address
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Address Line | 2950 BROAD ST # 1088
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City | SAN LUIS OBISPO
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State | CA
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Zip | 93401-6702
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Country | US
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Telephone | 805-888-1732
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Fax | 888-649-9179
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Authorized Official
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Title or Position | LMFT
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Name | KASSANDRA DAWN BOORTZ
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Credential | LMFT
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Telephone | 805-888-1732
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number |
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License Number State |
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