Healthcare Provider Details

I. General information

NPI: 1578480679
Provider Name (Legal Business Name): AMANDA BURNS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: AMANDA YI KEI CHEE

II. Dates (important events)

Enumeration Date: 07/01/2026
Last Update Date: 07/01/2026
Certification Date: 07/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

941 MARCO PL
VENICE CA
90291-3919
US

IV. Provider business mailing address

7750 MARYLAND AVE, PO BOX 11563
SAINT LOUIS MO
63105-9998
US

V. Phone/Fax

Practice location:
  • Phone: 702-849-8939
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number163577
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: