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NPI 1336759745

NPI 1336759745 : EFIGENIA FERRER BURNETTE ACSW : LOMA LINDA, CA

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General NPI Number Information
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    NPI Number           |    1336759745
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    Entity Type          |    Individual 
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    Provider Name        |    EFIGENIA FERRER BURNETTE ACSW
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    Gender               |    Female 
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Dates
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    Enumeration Date     |    08/01/2020
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    Last Update Date     |    04/12/2023
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Provider Practice Location Address
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    Address Line         |    11201 BENTON ST 
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    City                 |    LOMA LINDA
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    State                |    CA
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    Zip                  |    92357-1148
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    Country              |    US
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    Telephone            |    909-825-7084
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    6254 1/4 CATAWBA AVE 
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    City                 |    FONTANA
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    State                |    CA
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    Zip                  |    92336-4524
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    Country              |    US
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    Telephone            |    909-644-6686
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    Fax                  |    
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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        |    101YM0800X
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    Taxonomy Name        |    Mental Health Counselor
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    License Number       |    
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    License Number State |    
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Taxonomy #2
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    Taxonomy Code        |    104100000X
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    Taxonomy Name        |    Social Worker
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    License Number       |    
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    License Number State |    CA
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Taxonomy #3
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    Taxonomy Code        |    390200000X
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    Taxonomy Name        |    Student in an Organized Health Care Education/Training Program
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    License Number       |    
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    License Number State |    
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Taxonomy #4
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    Taxonomy Code        |    104100000X
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    Taxonomy Name        |    Social Worker
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    License Number       |    11372
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    License Number State |    CA
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