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NPI Code Detail

MEDICARE: NANCY BURNETT

MEDICARE: NANCY BURNETT
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1106S00000XBehavior Technician

General Provider Information

NPI Number : 1720580566
Entity Type Code : Individual
Provider Name (Legal Business Name) : NANCY BURNETT
Provider Business Mailing Address
First Line : 1603A SOUTH MAIN ST
Second Line :
City : MILPITAS
State : CA
Zip : 95035-6261
Country : US
Telephone Number : 408-913-5019
Fax Number :
Provider Business Practice Location Address
First Line : 1603A SOUTH MAIN ST
Second Line :
City : MILPITAS
State : CA
Zip : 95035-6261
Country : US
Telephone Number : 408-913-5019
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/07/2018
Last Update Date : 06/22/2020

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Directions to “ NANCY BURNETT ” Practice Location

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