Provider Demographics
NPI:1316121148
Name:BURTS, EMMANUEL JR
Entity type:Individual
Prefix:MR
First Name:EMMANUEL
Middle Name:
Last Name:BURTS
Suffix:JR
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:806 COLLINS AVE
Mailing Address - Street 2:
Mailing Address - City:FRESNO
Mailing Address - State:CA
Mailing Address - Zip Code:93706-3706
Mailing Address - Country:US
Mailing Address - Phone:559-237-0072
Mailing Address - Fax:
Practice Address - Street 1:806 COLLINS AVE
Practice Address - Street 2:
Practice Address - City:FRESNO
Practice Address - State:CA
Practice Address - Zip Code:93706-3706
Practice Address - Country:US
Practice Address - Phone:559-237-0072
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-12-28
Last Update Date:2007-12-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor