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NPI Code Detail

MEDICARE: MS. MARGARET LOIS GURMAN BURGESS LCSW

MEDICARE: MS. MARGARET LOIS GURMAN BURGESS LCSW
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
11041C0700XClinical Social Worker4196HI
21041C0700XClinical Social Worker74474CA

General Provider Information

NPI Number : 1194037663
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. MARGARET LOIS GURMAN BURGESS LCSW
Provider Business Mailing Address
First Line : 4098 VALETA ST UNIT 384
Second Line :
City : SAN DIEGO
State : CA
Zip : 92110-5825
Country : US
Telephone Number : 619-977-5461
Fax Number :
Provider Business Practice Location Address
First Line : 3411 3RD AVE
Second Line :
City : SAN DIEGO
State : CA
Zip : 92103-4906
Country : US
Telephone Number : 619-977-5461
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/13/2010
Last Update Date : 05/20/2020

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