Healthcare Provider Details

I. General information

NPI: 1194146217
Provider Name (Legal Business Name): MARI BURGESS MA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/16/2013
Last Update Date: 03/30/2026
Certification Date: 03/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1527 19TH ST STE 330
BAKERSFIELD CA
93301-4465
US

IV. Provider business mailing address

PO BOX 1559
BAKERSFIELD CA
93302-1559
US

V. Phone/Fax

Practice location:
  • Phone: 948-342-8600
  • Fax:
Mailing address:
  • Phone: 661-635-3050
  • Fax: 661-869-1503

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberLPCC18091
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number162527
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: