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CAROLINE BURNSIDE L.M.F.T., CHOM

>> Marriage & Family Therapist >> Behavioral Health & Social Service Providers

Registrant NPI Number: 1023029253

Individual Registrant:
 CAROLINE  BURNSIDE L.M.F.T., CHOM
Gender: F
Sole Proprietor

Location and contact information for practice:
10628 MELODY RD  BIG OAK VALLEY, CA 95977-9537 US
Tel: 530-432-6336  Fax: 530-432-6511

Contact information for business:
PO BOX 366  PENN VALLEY, CA 95946-0366 US
Tel: 530-432-6336  Fax: 530-432-6511

Registration Information:
NPI: 1023029253
Entity Type: Individual

Specialty information:

PrimaryCodeCategory/DescriptionStateLicense Number
Y106H00000XBehavioral Health & Social Service Providers
Marriage & Family Therapist
CAMFT20803

Legacy codes, insurance codes and state license numbers:

IssuerNumberStateType




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