| Doctor Name: | MS. JUDY LYNN BURGIO |
| NPI Number: | 1023345865 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | R.PH., C.N. |
| License Number: | RPH32400 |
| Business Practice Address: | 305 Morning Sun Ave Mill Valley, CA - 949413526 |
| Business Phone Number: | 4153831908 |
| Business Fax Number: | 4153898566 |
| Mailing Address: | 38 Miller Ave, Pmb 162 MILL VALLEY |
| State: | CA |
| Postal Code: | 949411927 |
| Phone Number: | 4153831908 |
| Fax Number: | 4153898566 |
| NPI Enumeration Date: | 11/16/2009 |
| NPI Last Update Date: | 11/16/2009 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 1835N1003X |
| License Number: | RPH32400 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | CA |
| Taxonomy Type: | Pharmacy Service Providers |
| Taxonomy Classification: | Pharmacist |
| Taxonomy Specialization: | Nutrition Support |
| Taxonomy Definition: | A licensed pharmacist who has demonstrated specialized knowledge and skill in maintenance and/or restoration of optimal nutritional status, designing and modifying treatment according to patient needs. |