Healthcare Provider Details

I. General information

NPI: 1457272817
Provider Name (Legal Business Name): LENAE BURNETT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: LENAE GARRETT

II. Dates (important events)

Enumeration Date: 07/22/2026
Last Update Date: 07/22/2026
Certification Date: 07/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1480 159TH AVE
ASHLAND CA
94578-2052
US

IV. Provider business mailing address

1480 159TH AVE
ASHLAND CA
94578-2052
US

V. Phone/Fax

Practice location:
  • Phone: 707-653-2154
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number155876
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: