Provider Demographics
NPI:1467693168
Name:BURNS, SHANA LINDSAY (MA, MFTI (IMF50099))
Entity Type:Individual
Prefix:
First Name:SHANA
Middle Name:LINDSAY
Last Name:BURNS
Suffix:
Gender:F
Credentials:MA, MFTI (IMF50099)
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:870 MARKET ST STE 1261
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94102-2917
Mailing Address - Country:US
Mailing Address - Phone:415-397-6622
Mailing Address - Fax:415-397-6666
Practice Address - Street 1:870 MARKET ST STE 1261
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94102-2917
Practice Address - Country:US
Practice Address - Phone:415-397-6622
Practice Address - Fax:415-397-6666
Is Sole Proprietor?:Yes
Enumeration Date:2009-03-10
Last Update Date:2009-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAIMF 50099106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist