Provider Demographics
NPI:1346407798
Name:BOOZER, ALGERNOL D (MSW)
Entity Type:Individual
Prefix:MR
First Name:ALGERNOL
Middle Name:D
Last Name:BOOZER
Suffix:
Gender:M
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7200 BANCROFT AVENUE SUITE 125A
Mailing Address - Street 2:
Mailing Address - City:OAKLAND
Mailing Address - State:CA
Mailing Address - Zip Code:94605
Mailing Address - Country:US
Mailing Address - Phone:510-777-3820
Mailing Address - Fax:510-777-3806
Practice Address - Street 1:7200 BANCROFT AVE STE 125A
Practice Address - Street 2:
Practice Address - City:OAKLAND
Practice Address - State:CA
Practice Address - Zip Code:94605-2457
Practice Address - Country:US
Practice Address - Phone:510-777-3820
Practice Address - Fax:510-777-3806
Is Sole Proprietor?:Yes
Enumeration Date:2008-05-21
Last Update Date:2010-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA232531041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical