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General NPI Number Information
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NPI Number | 1679314900
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Entity Type | Individual
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Provider Name | RAYMOND LEE BOOKER I MA, LPCC
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Gender | Male
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Dates
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Enumeration Date | 06/03/2024
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Last Update Date | 06/03/2024
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Provider Practice Location Address
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Address Line | 4401 ATLANTIC AVE STE 200
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City | LONG BEACH
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State | CA
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Zip | 90807-2264
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Country | US
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Telephone | 909-287-5056
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Fax |
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Provider Business Mailing Address
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Address Line | 7426 CHERRY AVE STE 210
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City | FONTANA
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State | CA
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Zip | 92336-4263
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Country | US
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Telephone | 909-202-5024
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101Y00000X
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Taxonomy Name | Counselor
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License Number | AMFT146599
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | AMFT146599
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License Number State | CA
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