Provider Demographics
NPI:1225578206
Name:BURIANEK, DEBRA (LMFT)
Entity Type:Individual
Prefix:
First Name:DEBRA
Middle Name:
Last Name:BURIANEK
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5005 LA MART DR STE 206
Mailing Address - Street 2:
Mailing Address - City:RIVERSIDE
Mailing Address - State:CA
Mailing Address - Zip Code:92507-8901
Mailing Address - Country:US
Mailing Address - Phone:951-880-4414
Mailing Address - Fax:951-880-0817
Practice Address - Street 1:7471 RUDELL RD
Practice Address - Street 2:
Practice Address - City:CORONA
Practice Address - State:CA
Practice Address - Zip Code:92881-4278
Practice Address - Country:US
Practice Address - Phone:951-900-4414
Practice Address - Fax:951-880-0817
Is Sole Proprietor?:No
Enumeration Date:2017-02-24
Last Update Date:2017-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA90848106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist