MEDICARE: MS. CATHERINE JANE BURNS L. AC.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	171100000X	Acupuncturist	4246	CA
2	171100000X	Acupuncturist	CA4246	CA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	EIN	OTHER	CA	770438660

General Provider Information

NPI Number	:	1043375777
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. CATHERINE JANE BURNS L. AC.

Provider Business Mailing Address
First Line	:	4546 EL CAMINO REAL
Second Line	:	SUITE B6
City	:	LOS ALTOS
State	:	CA
Zip	:	94022-1099
Country	:	US
Telephone Number	:	650-949-3637
Fax Number	:

Provider Business Practice Location Address
First Line	:	4546 EL CAMINO REAL
Second Line	:	SUITE B6
City	:	LOS ALTOS
State	:	CA
Zip	:	94022-1099
Country	:	US
Telephone Number	:	650-949-3637
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/22/2006
Last Update Date	:	10/07/2019

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