Provider Demographics
NPI:1487846531
Name:BURNS, WINIFRED MARY MARJORIE (PT)
Entity Type:Individual
Prefix:
First Name:WINIFRED
Middle Name:MARY MARJORIE
Last Name:BURNS
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1225 CRANE ST
Mailing Address - Street 2:SUITE 105
Mailing Address - City:MENLO PARK
Mailing Address - State:CA
Mailing Address - Zip Code:94025-4257
Mailing Address - Country:US
Mailing Address - Phone:650-323-3001
Mailing Address - Fax:650-323-7986
Practice Address - Street 1:1225 CRANE ST
Practice Address - Street 2:SUITE 105
Practice Address - City:MENLO PARK
Practice Address - State:CA
Practice Address - Zip Code:94025-4257
Practice Address - Country:US
Practice Address - Phone:650-323-3001
Practice Address - Fax:650-323-7986
Is Sole Proprietor?:No
Enumeration Date:2007-08-13
Last Update Date:2022-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPT20802225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist