Provider Demographics
NPI:1649390949
Name:ADAMS-BURNETT
Entity Type:Organization
Organization Name:ADAMS-BURNETT
Other - Org Name:BURNETTS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PARTNER ADMINISTRATOR
Authorized Official - Prefix:MS
Authorized Official - First Name:BONNIE
Authorized Official - Middle Name:M
Authorized Official - Last Name:ADAMS
Authorized Official - Suffix:
Authorized Official - Credentials:RN MSN EDD
Authorized Official - Phone:562-941-1384
Mailing Address - Street 1:9045 CARRON DRIVE
Mailing Address - Street 2:
Mailing Address - City:PICO RIVERA
Mailing Address - State:CA
Mailing Address - Zip Code:90660-3521
Mailing Address - Country:US
Mailing Address - Phone:562-942-7343
Mailing Address - Fax:562-696-2191
Practice Address - Street 1:9810 MARYKNOLL ST
Practice Address - Street 2:
Practice Address - City:WHITTIER
Practice Address - State:CA
Practice Address - Zip Code:90605-2940
Practice Address - Country:US
Practice Address - Phone:562-945-7455
Practice Address - Fax:562-696-2191
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ADAMS-BURNETT
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2007-03-30
Last Update Date:2008-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA9600000525320600000X
CA960000525320600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320600000XResidential Treatment FacilitiesResidential Treatment Facility, Intellectual and/or Developmental Disabilities
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA05G309OtherMEDICAL PROVIDER