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Contact Information

MANNY BURGESS
1910 HUNTINGTON DR
SOUTH PASADENA, CA91030-4812
 Phone: 626-441-6111
 Fax: 626-441-6389
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Clinical

103TC0700X 62 Psychologist, Clinical
Indicates primary specialty

NPI Profile & details for MANNY BURGESS · (Male)

NPI # 1013080290
Status Active
Credentials
Entity Individual
Enumeration date 11/16/2006
Last updated 07/08/2007 - About 12 years ago
Sole proprietor 1 Yes
Identifiers
  • CA License # PSY10843
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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