Provider Demographics
NPI:1487722989
Name:BURNEY, MAUREEN ANTOINETTE (PHD)
Entity type:Individual
Prefix:DR
First Name:MAUREEN
Middle Name:ANTOINETTE
Last Name:BURNEY
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13751 ROSWELL AVE
Mailing Address - Street 2:SUITE A
Mailing Address - City:CHINO
Mailing Address - State:CA
Mailing Address - Zip Code:91710-5464
Mailing Address - Country:US
Mailing Address - Phone:714-902-1001
Mailing Address - Fax:909-902-6055
Practice Address - Street 1:13751 ROSWELL AVE
Practice Address - Street 2:SUITE A
Practice Address - City:CHINO
Practice Address - State:CA
Practice Address - Zip Code:91710-5464
Practice Address - Country:US
Practice Address - Phone:714-902-1001
Practice Address - Fax:909-591-4033
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-01
Last Update Date:2020-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY12728103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical