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Individual

DR. BRIAN THOMAS BURGESS

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
PSYD

Contact information

Practice address
2292 ADRIENNE DR, CORONA, CA 92882-5113
(773) 318-2361
Mailing address
2292 ADRIENNE DR, CORONA, CA 92882-5113
(773) 318-2361

Taxonomy

Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
180008239
IL
103TC0700X
Clinical Psychologist
Primary
PSY31294
CA

Other

Enumeration date
08/20/2012
Last updated
04/26/2024
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