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MR. HENRY BURCIAGA MFT

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

Registrant NPI Number: 1487785705

Individual Registrant:
MR. HENRY  BURCIAGA MFT
Gender: M
Not Sole Proprietor

Location and contact information for practice:
14700 MANZANITA RD  BEAUMONT, CA 92223-3026 US
Tel: 951-845-3155  Fax: 951-845-8412

Contact information for business:
27555 E TRAIL RIDGE WAY APT 1094  MORENO VALLEY, CA 92555-4491 US
Tel: 310-908-8379  Fax: --

Registration Information:
NPI: 1487785705
Entity Type: Individual

Specialty information:

PrimaryCodeCategory/DescriptionStateLicense Number
N106H00000XBehavioral Health & Social Service Providers
Marriage & Family Therapist
CAMFC19940
N106H00000XBehavioral Health & Social Service Providers
Marriage & Family Therapist
Y106H00000XBehavioral Health & Social Service Providers
Marriage & Family Therapist
CAMFT19940

Legacy codes, insurance codes and state license numbers:

IssuerNumberStateType
00007300CA05




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