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MS. ANDREA LYNN BURSON CADC-II
>> Technician >> Nursing Service Related ProvidersRegistrant NPI Number: 1902391154
Individual Registrant:MS. ANDREA LYNN BURSON CADC-II
Gender: F
Not Sole Proprietor
Gender: F
Not Sole Proprietor
Location and contact information for practice:
1904 RICHLAND AVE CERES, CA 95307-4562 US
Tel: 209-525-7422 Fax: --
Tel: 209-525-7422 Fax: --
Contact information for business:
1904 RICHLAND AVE CERES, CA 95307-4562 US
Tel: 209-525-7422 Fax: --
Tel: 209-525-7422 Fax: --
Registration Information:
NPI: 1902391154
Entity Type: Individual
Entity Type: Individual
Specialty information:
| Primary | Code | Category/Description | State | License Number |
|---|---|---|---|---|
| Y | 374700000X | Nursing Service Related Providers Technician | CA | A022660316 |
Legacy codes, insurance codes and state license numbers:
| Issuer | Number | State | Type |
|---|---|---|---|
| 374700000 | CA | 05 |
