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General NPI Number Information
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NPI Number | 1194146217
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Entity Type | Individual
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Provider Name | MARI BURGESS MA
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Gender | Female
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Dates
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Enumeration Date | 12/16/2013
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Last Update Date | 11/25/2024
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Provider Practice Location Address
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Address Line | 3117 WILSON RD
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City | BAKERSFIELD
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State | CA
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Zip | 93304-5319
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Country | US
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Telephone | 661-397-8775
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Fax | 661-617-2098
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Provider Business Mailing Address
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Address Line | PO BOX 1559
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City | BAKERSFIELD
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State | CA
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Zip | 93302-1559
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Country | US
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Telephone | 661-635-3050
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Fax | 661-869-1503
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | 130910
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | LPCC18091
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License Number State | CA
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