Most Relevant Information
Provider Data
| NPI Number: | 1003408782 |
| Provider Name: | RICKY BURNELL |
| Entity Type: | Individual |
| Taxonomy Code: | 101YA0400X |
| Specialty: | Counselor |
| License Number: |
Most Important Dates
| Enumeration Date: | 02/04/2021 |
| Last Updated: | 02/04/2021 |
Provider Practice Location
771 W ORANGETHORPE AVE
FULLERTON
CA
928322806
Practice Location Phone/Fax
| Phone: | 7148790929 |
| Fax: |
Provider Mailing Location
771 W ORANGETHORPE AVE
FULLERTON
CA
928322806
Provider Mailing Phone/Fax
| Phone: | 7148790929 |
| Fax: |