| Mrs Krystal Marie Boothe, LCSW | |
|
117 E Colorado Blvd, Pasadena, CA 91105-1938 | |
| (661) 402-1545 | |
| (661) 727-0006 |
| Full Name | Mrs Krystal Marie Boothe |
|---|---|
| Gender | Female |
| Speciality | Social Worker - Clinical |
| Location | 117 E Colorado Blvd, Pasadena, California |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1043488414 | NPI | - | NPPES |
| 9999999999 | Other | CA | BLUE CROSS |
| 99999999999999 | Medicaid | CA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | LCSW71811 (California) | Primary |
| Entity Name | Wings Of The Future Private Practice Lcsw Pc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1144705724 PECOS PAC ID: 8729488440 Enrollment ID: O20220223000697 |
| Mailing Address | Practice Location Address |
|---|---|
| Mrs Krystal Marie Boothe, LCSW 1308 Island Vista Dr, Arlington, TX 76005-1375 Ph: (310) 621-0150 | Mrs Krystal Marie Boothe, LCSW 117 E Colorado Blvd, Pasadena, CA 91105-1938 Ph: (661) 402-1545 |
Luisana Marquez, Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 351 S Hudson Ave Rm 206, Pasadena, CA 91101 Phone: 626-396-3600 | |
Chloe Camarena, Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 867 N Fair Oaks Ave, Pasadena, CA 91103 Phone: 999-999-9999 | |
Charles Evans, Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 2471 E Walnut St, Pasadena, CA 91107 Phone: 626-793-5141 | |
Melissa Mary Sagami-peck, Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 210 S De Lacey Ave, Suite 110, Pasadena, CA 91105 Phone: 626-395-7100 | |
Abigail Resendiz-zuniga, MSW, ASW Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 459 E Colorado Blvd, Pasadena, CA 91101 Phone: 800-488-3414 | |
Mr. Alfred Koon-ho Chow, Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 447 N El Molino Ave, Pasadena, CA 91101 Phone: 626-577-8480 | |
Ms. Mari Lacressa Martin, L.C.S.W. Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 1520 N Raymond Ave Bldg 2-7, Pasadena, CA 91103 Phone: 626-396-5920 |