Provider Demographics
NPI:1043375777
Name:BURNS, CATHERINE JANE (L AC)
Entity Type:Individual
Prefix:MS
First Name:CATHERINE
Middle Name:JANE
Last Name:BURNS
Suffix:
Gender:F
Credentials:L AC
Other - Prefix:MS
Other - First Name:CATHERINE
Other - Middle Name:JANE
Other - Last Name:BURNS
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:L AC
Mailing Address - Street 1:4546 EL CAMINO REAL
Mailing Address - Street 2:SUITE B6
Mailing Address - City:LOS ALTOS
Mailing Address - State:CA
Mailing Address - Zip Code:94022-1099
Mailing Address - Country:US
Mailing Address - Phone:650-949-3637
Mailing Address - Fax:
Practice Address - Street 1:4546 EL CAMINO REAL
Practice Address - Street 2:SUITE B6
Practice Address - City:LOS ALTOS
Practice Address - State:CA
Practice Address - Zip Code:94022-1099
Practice Address - Country:US
Practice Address - Phone:650-949-3637
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-22
Last Update Date:2019-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA4246171100000X
CACA4246171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAEINOther770438660