Provider Demographics
NPI:1396368833
Name:BURGET, AMBER RENEE (RN, PHN)
Entity Type:Individual
Prefix:
First Name:AMBER
Middle Name:RENEE
Last Name:BURGET
Suffix:
Gender:F
Credentials:RN, PHN
Other - Prefix:
Other - First Name:AMBER
Other - Middle Name:RENEE
Other - Last Name:MAHAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:7001A EAST PKWY
Mailing Address - Street 2:
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95823-2501
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:9616 MICRON AVE
Practice Address - Street 2:
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95827-2625
Practice Address - Country:US
Practice Address - Phone:916-875-5000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-05-19
Last Update Date:2020-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA8448962083P0901X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2083P0901XAllopathic & Osteopathic PhysiciansPreventive MedicinePublic Health & General Preventive Medicine