Healthcare Provider Details

I. General information

NPI: 1457961260
Provider Name (Legal Business Name): SUNNY RENEE BURDICK AU.D
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: SUNNY RENEE BURDICK SUNNY BARTHA

II. Dates (important events)

Enumeration Date: 08/06/2020
Last Update Date: 08/06/2020
Certification Date: 08/06/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10535 HOSPITAL WAY
MATHER CA
95655-4200
US

IV. Provider business mailing address

3817 MARYSVILLE BLVD
SACRAMENTO CA
95838-5204
US

V. Phone/Fax

Practice location:
  • Phone: 916-843-7000
  • Fax:
Mailing address:
  • Phone: 480-298-6490
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code231H00000X
TaxonomyAudiologist
License NumberAT006681
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: