Provider Demographics
NPI:1699961805
Name:BOOKER, THOMISHIA STARR
Entity type:Individual
Prefix:MS
First Name:THOMISHIA
Middle Name:STARR
Last Name:BOOKER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:231 MARKET PL
Mailing Address - Street 2:105
Mailing Address - City:SAN RAMON
Mailing Address - State:CA
Mailing Address - Zip Code:94583-4743
Mailing Address - Country:US
Mailing Address - Phone:510-909-7034
Mailing Address - Fax:
Practice Address - Street 1:777 N 1ST ST
Practice Address - Street 2:SUITE 444
Practice Address - City:SAN JOSE
Practice Address - State:CA
Practice Address - Zip Code:95112-6337
Practice Address - Country:US
Practice Address - Phone:408-240-0070
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-09-20
Last Update Date:2016-12-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101YM0800X
CA74978101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health