Booker, Edna Faye

Booker, Edna Faye is an individual health care provider with primary practice located at 222 E Main St Ste 117 , Barstow CA 92311-2361. She recently has 3 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder), Behavioral Health & Social Service Providers / Mental Health, Behavioral Health & Social Service Providers / Professional. Behavioral Health & Social Service Providers / Professional is her primary health care specialty. Booker, Edna Faye can be contacted via phone (760) 255-1497.

Contact Information

Primary practice address
222 E Main St Ste 117 Barstow CA 92311-2361
Phone: (760) 255-1497
Fax: (760) 256-2920
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder) 101YA0400X 5034 Louisiana
Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder) 101YA0400X 15179 Arizona
Behavioral Health & Social Service Providers / Mental Health 101YM0800X 4179 Louisiana
Behavioral Health & Social Service Providers / Professional 101YP2500X 17302 Arizona

Profile Details

NPI number 1801193834
LBN Legal business name Booker, Edna Faye
Credentials LPC, LISAC
Entity Individual
Sole proprietor 1 No
Enumeration date Feb 28th, 2011
Last updated Jun 4th, 2024 - about 2 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1801193834 NPPES
California MEDICAID 1801193834

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