Provider Demographics
NPI:1508225541
Name:BORUNDA, JAMES ELLIOTT
Entity Type:Individual
Prefix:
First Name:JAMES
Middle Name:ELLIOTT
Last Name:BORUNDA
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:138 W MORTON AVE
Mailing Address - Street 2:
Mailing Address - City:FRESNO
Mailing Address - State:CA
Mailing Address - Zip Code:93706-6057
Mailing Address - Country:US
Mailing Address - Phone:559-347-1769
Mailing Address - Fax:
Practice Address - Street 1:138 W MORTON AVE
Practice Address - Street 2:
Practice Address - City:FRESNO
Practice Address - State:CA
Practice Address - Zip Code:93706-6057
Practice Address - Country:US
Practice Address - Phone:559-347-1769
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-02-18
Last Update Date:2016-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)