Provider Demographics
NPI:1578681680
Name:BOOKER, DON THANE (MA)
Entity Type:Individual
Prefix:MR
First Name:DON
Middle Name:THANE
Last Name:BOOKER
Suffix:
Gender:M
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:363 FRANKLIN LN
Mailing Address - Street 2:
Mailing Address - City:VENTURA
Mailing Address - State:CA
Mailing Address - Zip Code:93001-1419
Mailing Address - Country:US
Mailing Address - Phone:805-652-0835
Mailing Address - Fax:
Practice Address - Street 1:7266 ALAMEDA AVE
Practice Address - Street 2:DOS PUEBLOS HIGH SCHOOL
Practice Address - City:GOLETA
Practice Address - State:CA
Practice Address - Zip Code:93117-1351
Practice Address - Country:US
Practice Address - Phone:805-968-2541
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-03-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health