Provider Demographics
NPI:1528370285
Name:BURTON, CONSTANCE DOWD (PSYD, JD)
Entity Type:Individual
Prefix:DR
First Name:CONSTANCE
Middle Name:DOWD
Last Name:BURTON
Suffix:
Gender:F
Credentials:PSYD, JD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:179 PRIMROSE WAY
Mailing Address - Street 2:
Mailing Address - City:PALO ALTO
Mailing Address - State:CA
Mailing Address - Zip Code:94303-3047
Mailing Address - Country:US
Mailing Address - Phone:650-465-5527
Mailing Address - Fax:
Practice Address - Street 1:800 MENLO AVE STE 209
Practice Address - Street 2:
Practice Address - City:MENLO PARK
Practice Address - State:CA
Practice Address - Zip Code:94025-4732
Practice Address - Country:US
Practice Address - Phone:650-465-5527
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-07-10
Last Update Date:2010-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY23188103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical