=====================================================
General NPI Number Information
=====================================================
NPI Number | 1609237924
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | CHRISTOPHER A. BURR PH.D.
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 03/14/2016
-----------------------------------------------------
Last Update Date | 03/14/2016
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 100 E THOUSAND OAKS BLVD SUITE 140
-----------------------------------------------------
City | THOUSAND OAKS
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 91360-5713
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 424-354-7170
-----------------------------------------------------
Fax | 805-230-1222
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 100 E THOUSAND OAKS BLVD SUITE 140
-----------------------------------------------------
City | THOUSAND OAKS
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 91360-5713
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 424-354-7170
-----------------------------------------------------
Fax | 805-230-1222
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | PSYCHOLOGIST
-----------------------------------------------------
Name | DR. CHRISTOPHER ALAN BURR
-----------------------------------------------------
Credential | PH.D.
-----------------------------------------------------
Telephone | 424-354-7170
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 261QM0850X
-----------------------------------------------------
Taxonomy Name | Adult Mental Health Clinic/Center
-----------------------------------------------------
License Number | PSY13656
-----------------------------------------------------
License Number State | CA
-----------------------------------------------------