Basic Information
| Provider Information | |||||||||
| NPI: | 1184793572 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | THOMAS-BURNS | ||||||||
| FirstName: | VANESSA | ||||||||
| MiddleName: | M. | ||||||||
| NamePrefix: | MRS. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 3171 OAK KNOLL DR | ||||||||
| Address2: | |||||||||
| City: | LOS ALAMITOS | ||||||||
| State: | CA | ||||||||
| PostalCode: | 907204516 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5624309705 | ||||||||
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| Practice Location | |||||||||
| Address1: | 1300 S GRAND AVE | ||||||||
| Address2: | |||||||||
| City: | SANTA ANA | ||||||||
| State: | CA | ||||||||
| PostalCode: | 927054434 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7145677681 | ||||||||
| FaxNumber: | 7148346825 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 11/07/2006 | ||||||||
| LastUpdateDate: | 07/08/2007 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 106H00000X | MFC37210 | CA | Y | Behavioral Health & Social Service Providers | Marriage & Family Therapist |
No ID Information.