Provider Demographics
NPI:1053662072
Name:BURGNER, DANAE M (LMFT)
Entity type:Individual
Prefix:MS
First Name:DANAE
Middle Name:M
Last Name:BURGNER
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:705 PIER VIEW WAY STE A
Mailing Address - Street 2:
Mailing Address - City:OCEANSIDE
Mailing Address - State:CA
Mailing Address - Zip Code:92054-2848
Mailing Address - Country:US
Mailing Address - Phone:442-500-8200
Mailing Address - Fax:
Practice Address - Street 1:705 PIER VIEW WAY STE A
Practice Address - Street 2:
Practice Address - City:OCEANSIDE
Practice Address - State:CA
Practice Address - Zip Code:92054-2848
Practice Address - Country:US
Practice Address - Phone:442-500-8200
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-10-01
Last Update Date:2020-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA106848106H00000X
CA74166106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist