Provider Demographics
NPI:1619325370
Name:BURROWS, JOANNE MARY (MA)
Entity Type:Individual
Prefix:MS
First Name:JOANNE
Middle Name:MARY
Last Name:BURROWS
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:220 NATAQUA AVE
Mailing Address - Street 2:
Mailing Address - City:PACIFICA
Mailing Address - State:CA
Mailing Address - Zip Code:94044-3145
Mailing Address - Country:US
Mailing Address - Phone:510-684-0656
Mailing Address - Fax:650-898-8949
Practice Address - Street 1:220 NATAQUA AVE
Practice Address - Street 2:
Practice Address - City:PACIFICA
Practice Address - State:CA
Practice Address - Zip Code:94044-3145
Practice Address - Country:US
Practice Address - Phone:510-684-0656
Practice Address - Fax:650-898-8949
Is Sole Proprietor?:Yes
Enumeration Date:2016-06-02
Last Update Date:2016-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFC 44757106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist