Provider Demographics
NPI:1649436643
Name:BURR, GLENDA L (PSY D)
Entity type:Individual
Prefix:DR
First Name:GLENDA
Middle Name:L
Last Name:BURR
Suffix:
Gender:F
Credentials:PSY D
Other - Prefix:
Other - First Name:GLENDA
Other - Middle Name:L
Other - Last Name:GONZALEZ
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PSY D
Mailing Address - Street 1:4104 24TH ST STE 521
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94114-3615
Mailing Address - Country:US
Mailing Address - Phone:415-775-7766
Mailing Address - Fax:415-775-7730
Practice Address - Street 1:825 VAN NESS AVE STE 503
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94109-7893
Practice Address - Country:US
Practice Address - Phone:415-775-7766
Practice Address - Fax:415-775-7730
Is Sole Proprietor?:Yes
Enumeration Date:2008-07-30
Last Update Date:2018-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No103T00000XBehavioral Health & Social Service ProvidersPsychologist
No103TC2200XBehavioral Health & Social Service ProvidersPsychologistClinical Child & Adolescent
No103TF0000XBehavioral Health & Social Service ProvidersPsychologistFamily
No106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist