| Doctor Name: | MR. RANDALL LEO BURDEN |
| NPI Number: | 1184886756 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | LMFT |
| License Number: | MFCC 34409 |
| Business Practice Address: | 10662 Maple Ave Hesperia, CA - 923452436 |
| Business Phone Number: | 9098163327 |
| Business Fax Number: | 9099204206 |
| Mailing Address: | 10662 Maple Ave, HESPERIA |
| State: | CA |
| Postal Code: | 923452436 |
| Phone Number: | 9098163327 |
| Fax Number: | 9099204206 |
| NPI Enumeration Date: | 06/25/2008 |
| NPI Last Update Date: | 05/10/2012 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YA0400X |
| License Number: | MFCC 34409 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | CA |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Addiction (Substance Use Disorder) |
| Taxonomy Definition: | |