Provider Demographics
NPI:1942493937
Name:BURNS, ISAAC L (MFT)
Entity Type:Individual
Prefix:MR
First Name:ISAAC
Middle Name:L
Last Name:BURNS
Suffix:
Gender:M
Credentials:MFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:43 QUAIL CT
Mailing Address - Street 2:STE 203A
Mailing Address - City:WALNUT CREEK
Mailing Address - State:CA
Mailing Address - Zip Code:94596-8701
Mailing Address - Country:US
Mailing Address - Phone:925-743-0720
Mailing Address - Fax:925-743-0720
Practice Address - Street 1:43 QUAIL CT
Practice Address - Street 2:STE 203A
Practice Address - City:WALNUT CREEK
Practice Address - State:CA
Practice Address - Zip Code:94596-8701
Practice Address - Country:US
Practice Address - Phone:925-743-0720
Practice Address - Fax:925-743-0720
Is Sole Proprietor?:Yes
Enumeration Date:2007-08-22
Last Update Date:2007-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFC44245106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist