Individual
SIDNEY BURGESS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
ECMZA
Contact information
Practice address
527 S STATE ST, UKIAH, CA 95482-4910
(707) 672-6153
Mailing address
500 COCHRANE AVE, UKIAH, CA 95482-5621
(707) 672-6153
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
—
—
171400000X
Health & Wellness Coach
Primary
—
—
373H00000X
Day Training/Habilitation Specialist
—
—
3747P1801X
Personal Care Attendant
—
—
374K00000X
Religious Nonmedical Practitioner
—
—
374U00000X
Home Health Aide
—
—
Other
Enumeration date
03/03/2025
Last updated
03/03/2025
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