Booth, Ken O

Booth, Ken O is an individual health care provider with primary practice located at 2101 Courage Dr , Fairfield CA 94533-6717. He recently has only one registered license in Nursing Service Providers / Licensed Psychiatric Technician, which is considered as his primary health care specialty. Booth, Ken O can be contacted via phone (707) 428-1131.

Contact Information

Primary practice address
2101 Courage Dr Fairfield CA 94533-6717
Phone: (707) 428-1131
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Nursing Service Providers / Licensed Psychiatric Technician 167G00000X PT37597 California

Profile Details

NPI number 1841975786
LBN Legal business name Booth, Ken O
Credentials
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 19th, 2023
Last updated Jun 19th, 2023 - about 3 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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