Kristin Ann Boomer, MSW
Social Worker, Clinical in Oakland, CA. Individual provider (NPI-1).
NPI number1063662476
StatusActive
Last updated in NPPESSep 22, 2008
Details
- NPI
- 1063662476
- Entity type
- Individual (NPI-1)
- Name
- Kristin Ann Boomer
- Credential
- MSW
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Sep 22, 2008
- Last updated
- Sep 22, 2008
Medicare and OIG
- Medicare enrolled (PECOS)
- Not in the Medicare enrollment file
- Can order and refer
- Not on the CMS order and referring list
- OIG exclusion list
- This NPI is not listed
CMS and OIG files of November 2026. PECOS lookup · OIG exclusion check
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 1041C0700X | Social Worker, Clinical | – | – | Yes |
Practice location
2850 West StOakland, CA 94608-4536
Phone 510-879-8481 · Fax 510-879-2416
Mailing address
2850 West StOakland, CA 94608-4536
Phone 510-879-8481 · Fax 510-879-2416
Is something wrong?
This page shows exactly what the provider filed with NPPES. Only the provider (or their surrogate) can change it, by signing in to NPPES. Our page updates within a day of their change. See how to update NPI information.
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