Manny Burgess is a Clinical in South Pasadena, California. Manny Burgess practices all healthcare services and medical treatments related to Clinical. The NPI Number for Manny Burgess is 1013080290. The last update date is 2007-07-08.
Manny Burgess's current location address is 1910 Huntington Dr, South Pasadena, California. You can contact this provider via phone number 6264416111 and fax number 6264416389. The mailing address for Manny Burgess is 1910 Huntington Dr, South Pasadena, California. To know further, please read the information below!
Provider Profile Detail
| Provider Name | Manny Burgess |
|---|---|
| Address | 1910 Huntington Dr, South Pasadena, California |
| Phone Number | 6264416111 |
| Fax Number | 6264416389 |
| Sole Proprietor | Y |
| Credentials | -- |
NPI Number Detail
| NPI Number | 1013080290 |
|---|---|
| Provider Enumeration Date | 2006-11-16 |
| Last Updated Date | 2007-07-08 |
Provider Mailing Address Detail
| Address | 1910 Huntington Dr |
|---|---|
| City | South Pasadena |
| State | California (CA) |
| Post Code | 910304812 |
| Phone Number | 6264416111 |
| Fax Number | 6264416389 |
Provider's Primary Taxonomy Detail
| Speciality | Clinical |
|---|---|
| Taxonomy | 103Tc0700X |
| Licence No | PSY10843 |
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Definition: A psychologist who provides continuing and comprehensive mental and behavioral health care for individuals and families; consultation to agencies and communities; training, education and supervision; and research-based practice. It is a specialty in |
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What is the unique 10-digit identification code issued to Manny Burgess by the Centers for Medicare & Medicaid Services?
The Manny Burgess has been assigned the NPI (National Provider Identifier) 1013080290 by the Centers for Medicare & Medicaid Services (CMS). This 10-digit code serves as a unique identifier for healthcare providers.
Could you please provide the complete street address where Manny Burgess is physically located?
The Manny Burgess is physically situated at the following address: 1910 Huntington Dr, South Pasadena, CA, 910304812.
What is the Manny Burgess's specialty and taxonomy code?
The Manny Burgess's specialty is Clinical, and the corresponding taxonomy code is 103Tc0700X.
When did Manny Burgess receive its 1013080290 assignment?
The Manny Burgess was assigned its 1013080290 on 2006-11-16, which is the date when this unique identifier was issued to the organization.
As of what date was the information regarding Manny Burgess, such as address, specialty, and other details, last verified and confirmed to be up-to-date?
The information related to Manny Burgess, including its address, specialty, and other relevant details, was last verified and confirmed to be up-to-date on 2007-07-08.
NPI Number: 1528061793
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