Provider Demographics
NPI:1295228476
Name:BURTON, KAREN EARLY (MA, PSYCHOLOGY)
Entity Type:Individual
Prefix:
First Name:KAREN
Middle Name:EARLY
Last Name:BURTON
Suffix:
Gender:F
Credentials:MA, PSYCHOLOGY
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 6300
Mailing Address - Street 2:
Mailing Address - City:CRESTLINE
Mailing Address - State:CA
Mailing Address - Zip Code:92325-6300
Mailing Address - Country:US
Mailing Address - Phone:909-665-0128
Mailing Address - Fax:
Practice Address - Street 1:340 HIGHWAY 138
Practice Address - Street 2:
Practice Address - City:CRESTLINE
Practice Address - State:CA
Practice Address - Zip Code:92325
Practice Address - Country:US
Practice Address - Phone:909-336-3339
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-06-12
Last Update Date:2018-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator