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JEFFREY LYNN BOONE
Addiction (Substance Use Disorder) >> Counselor >> Behavioral Health & Social Service ProvidersRegistrant NPI Number: 1992946297
Individual Registrant: JEFFREY LYNN BOONE
Gender: M
Not Sole Proprietor
Gender: M
Not Sole Proprietor
Location and contact information for practice:
1904 RICHLAND AVE CERES, CA 95307-4562 US
Tel: 209-541-2121 Fax: 209-541-2114
Tel: 209-541-2121 Fax: 209-541-2114
Contact information for business:
1904 RICHLAND AVE CERES, CA 95307-4562 US
Tel: 209-541-2121 Fax: 209-541-2114
Tel: 209-541-2121 Fax: 209-541-2114
Registration Information:
NPI: 1992946297
Entity Type: Individual
Entity Type: Individual
Specialty information:
| Primary | Code | Category/Description | State | License Number |
|---|---|---|---|---|
| Y | 101YA0400X | Behavioral Health & Social Service Providers Counselor Addiction (Substance Use Disorder) |
Legacy codes, insurance codes and state license numbers:
| Issuer | Number | State | Type |
|---|---|---|---|
