Provider Demographics
NPI:1174068027
Name:BURNS, TAMARA (LPCC)
Entity type:Individual
Prefix:
First Name:TAMARA
Middle Name:
Last Name:BURNS
Suffix:
Gender:F
Credentials:LPCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:33175 TEMECULA PKWY
Mailing Address - Street 2:SUITE A312
Mailing Address - City:TEMECULA
Mailing Address - State:CA
Mailing Address - Zip Code:92592-7310
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:32605 TEMECULA PKWY
Practice Address - Street 2:SUITE 207
Practice Address - City:TEMECULA
Practice Address - State:CA
Practice Address - Zip Code:92592-6837
Practice Address - Country:US
Practice Address - Phone:951-284-6401
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-01-02
Last Update Date:2017-01-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALPCC653101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional