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General NPI Number Information
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NPI Number | 1528370285
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Entity Type | Individual
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Provider Name | CONSTANCE DOWD BURTON PSYD, JD
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Gender | Female
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Dates
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Enumeration Date | 07/10/2010
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Last Update Date | 07/10/2010
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Provider Practice Location Address
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Address Line | 800 MENLO AVE STE 209
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City | MENLO PARK
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State | CA
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Zip | 94025-4732
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Country | US
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Telephone | 650-465-5527
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Fax |
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Provider Business Mailing Address
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Address Line | 179 PRIMROSE WAY
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City | PALO ALTO
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State | CA
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Zip | 94303-3047
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Country | US
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Telephone | 650-465-5527
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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 | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | PSY23188
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License Number State | CA
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