Individual provider Active NPI

Pamela Burney

  • Marriage & Family Therapist
  • Fontana, CA
National Provider Identifier
1205360575
Registry record updated Apr 13, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
Practice address
15213 Willow Wood LN
Fontana, CA 92336-0786
Phone
(909) 730-8974
NPI assigned
Apr 13, 2017
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 13, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family Therapist 106H00000X Primary

Addresses

Primary practice location

15213 Willow Wood LN
Fontana, CA 92336-0786

Mailing address

15213 Willow Wood LN
Fontana, CA 92336-0786
Phone (909) 730-8974

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240214004127 CA Practitioner - Marriage and Family Therapist 5799129029 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Marriage and Family Therapist
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
High Desert Psychological ServicesGroup PAC ID 2860819125, 82 clinicians

Practice addresses (Care Compare)

15497 W Sand St
Victorville, CA 92392-2910
Phone (442) 327-9311

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
High Desert Psychological Services Marriage & Family Therapist CurrentSince Jan 1, 2024 Accepting new patients

Locations

8253 White Oak Ave
Rch Cucamonga, CA 91730
Phone (909) 987-1997

15497 W Sand St
Victorville, CA 92392
Phone (442) 327-9311

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1492041600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1492041600000",
    "number": "1205360575",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15213 WILLOW WOOD LN",
            "city": "FONTANA",
            "state": "CA",
            "postal_code": "923360786",
            "telephone_number": "909-730-8974"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15213 WILLOW WOOD LN",
            "city": "FONTANA",
            "state": "CA",
            "postal_code": "923360786",
            "telephone_number": "909-730-8974"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BURNEY",
        "first_name": "PAMELA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-04-13",
        "last_updated": "2017-04-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fontana, CA

Sources for this page

Verify at the official NPI Registry.