Sharon Marie Booth, MSW LCSW

Individual provider Active NPI Clinical Social Worker · Cameron Park, CA

NPI 1487740346 · NPPES record last updated Jul 8, 2007

Key facts

NPI
1487740346
Entity type
Individual (NPI type 1)
Primary specialty
Clinical Social Worker 1041C0700X
License
LCS5729 (CA)
Practice address
4120 Cameron Park Dr
Ste 403
Cameron Park, CA 95682
Phone
(530) 677-5764
Fax
(530) 676-1782
NPI assigned
Oct 5, 2006
Sex
Female
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
LCS5729CAMDClinical Social Worker

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X LCS5729 CA Yes

Addresses

Primary practice location

4120 Cameron Park Dr
Ste 403
Cameron Park, CA 95682

Mailing address

4120 Cameron Park Dr
Ste 403
Cameron Park, CA 95682
Phone (530) 677-5764

Other identifiers

IdentifierTypeStateIssuer
ZZZ26296ZOtherCABLUE SHIELD
6250764OtherUBH
0000033137051117OtherMHN
069574OtherVO
0004318938OtherAETNA

Other providers in Cameron Park, CA

All providers in Cameron Park, CA · Clinical Social Worker in California

Sources for this page

Verify at the official NPI Registry.