Individual
KEEVAN BURRIES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
3881 S WESTERN AVE, LOS ANGELES, CA 90062-1105
(323) 290-4340
Mailing address
510 S SPRING ST APT 306, LOS ANGELES, CA 90013-2065
(213) 924-4963
Taxonomy
Speciality
Code
Description
License number
State
167G00000X
Licensed Psychiatric Technician
Primary
LPT42366
CA
Other
Enumeration date
12/22/2022
Last updated
12/22/2022
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