Provider Demographics
NPI:1750548731
Name:BURROW, RETHA (RN)
Entity type:Individual
Prefix:MRS
First Name:RETHA
Middle Name:
Last Name:BURROW
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:41002 COUNTY CENTER DR
Mailing Address - Street 2:#320
Mailing Address - City:TEMECULA
Mailing Address - State:CA
Mailing Address - Zip Code:92591-6027
Mailing Address - Country:US
Mailing Address - Phone:951-600-6355
Mailing Address - Fax:951-600-6365
Practice Address - Street 1:41002 COUNTY CENTER DR
Practice Address - Street 2:#320
Practice Address - City:TEMECULA
Practice Address - State:CA
Practice Address - Zip Code:92591-6027
Practice Address - Country:US
Practice Address - Phone:951-600-6355
Practice Address - Fax:951-600-6365
Is Sole Proprietor?:Yes
Enumeration Date:2008-05-19
Last Update Date:2008-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA361478163WP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WP0808XNursing Service ProvidersRegistered NursePsychiatric/Mental Health