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NPI Code Detail

MEDICARE: CASSANDRA LYNN BOOKER RADT-I

MEDICARE: CASSANDRA LYNN BOOKER RADT-I
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101YA0400XAddiction (Substance Use Disorder) CounselorR158500823CA

General Provider Information

NPI Number : 1720861917
Entity Type Code : Individual
Provider Name (Legal Business Name) : CASSANDRA LYNN BOOKER RADT-I
Provider Business Mailing Address
First Line : 5655 ARDILLA AVE
Second Line :
City : ATASCADERO
State : CA
Zip : 93422-3222
Country : US
Telephone Number : 805-464-4660
Fax Number :
Provider Business Practice Location Address
First Line : 5655 ARDILLA AVE
Second Line :
City : ATASCADERO
State : CA
Zip : 93422-3222
Country : US
Telephone Number : 805-464-4660
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/14/2023
Last Update Date : 08/14/2023

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Directions to “ CASSANDRA LYNN BOOKER RADT-I” Practice Location

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