Benece Juanda Booker, M.A,

Individual provider Active NPI Mental Health Counselor · Hercules, CA

NPI 1992036065 · NPPES record last updated Jan 28, 2010

Key facts

NPI
1992036065
Entity type
Individual (NPI type 1)
Primary specialty
Mental Health Counselor 101YM0800X
License
61966 (CA)
Practice address
100 Copper Beech GLN
Hercules, CA 94547-2667
Phone
(510) 485-4851
NPI assigned
Jan 28, 2010
Sex
Female
Sole proprietor
Yes

Medicare participation

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

National Provider Directory

Medicare enrollment (NPD)
No
Credentials
Master of Arts

State licenses

LicenseStateTypeSpecialty
61966CAMDMental Health Counselor

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X 61966 CA Yes

Addresses

Primary practice location

100 Copper Beech GLN
Hercules, CA 94547-2667

Mailing address

100 Copper Beech GLN
Hercules, CA 94547-2667
Phone (510) 485-4851

Other providers in Hercules, CA

All providers in Hercules, CA · Mental Health Counselor in California

Sources for this page

Verify at the official NPI Registry.