Individual
WILAIM DAVID BOORMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PSYCHIATRIC TECHNICI
Contact information
Practice address
2178 JOHNSON AVE, SAN LUIS OBISPO, CA 93401-4535
(805) 237-3170
(805) 226-3207
Mailing address
7455 BALBOA RD, ATASCADERO, CA 93422-1188
(805) 466-6206
Taxonomy
Speciality
Code
Description
License number
State
167G00000X
Licensed Psychiatric Technician
Primary
PT 28462
CA
Other
Enumeration date
12/04/2006
Last updated
07/08/2007
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