Individual provider Active NPI

Evelyn Burruss

  • Clinical Nurse Specialist
  • Fresno, CA
National Provider Identifier
1104044171
Registry record updated Sep 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Nurse SpecialistTaxonomy code 364S00000X
License
2226 Issued in CA
Practice address
1221 Fulton Mall
Fresno, CA 93721-1915
Phone
(559) 445-3449
Fax
(559) 445-3370
NPI assigned
Apr 23, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 11, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 262863 CA
Clinical Nurse Specialist 364S00000X 2226 CA Primary

Addresses

Primary practice location

1221 Fulton Mall
Fresno, CA 93721-1915

Mailing address

1221 Fulton Mall
Fresno, CA 93721-1915
Phone (559) 445-3449

Other names 1

  • Ms. Evelyn Lucille Burruss Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
262863CAMDRegistered Nurse

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1177286400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1757548800000",
    "number": "1104044171",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1221 FULTON MALL",
            "city": "FRESNO",
            "state": "CA",
            "postal_code": "937211915",
            "telephone_number": "559-445-3449",
            "fax_number": "559-445-3370"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1221 FULTON MALL",
            "city": "FRESNO",
            "state": "CA",
            "postal_code": "937211915",
            "telephone_number": "559-445-3449",
            "fax_number": "559-445-3370"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BURRUSS",
        "first_name": "EVELYN",
        "name_prefix": "Ms.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-04-23",
        "last_updated": "2025-09-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "CA",
            "license": "262863",
            "primary": false
        },
        {
            "code": "364S00000X",
            "taxonomy_group": "",
            "desc": "Clinical Nurse Specialist",
            "state": "CA",
            "license": "2226",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "EVELYN",
            "last_name": "BURRUSS",
            "middle_name": "LUCILLE",
            "prefix": "MS.",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Fresno, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.