Healthcare Provider Details

I. General information

NPI: 1831561869
Provider Name (Legal Business Name): CHRIS P BURKE SR. CADC-CAS
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/29/2015
Last Update Date: 12/12/2024
Certification Date: 12/12/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4129 STATE ST
SANTA BARBARA CA
93110-1848
US

IV. Provider business mailing address

4129 STATE ST
SANTA BARBARA CA
93110-1848
US

V. Phone/Fax

Practice location:
  • Phone: 805-964-4795
  • Fax:
Mailing address:
  • Phone: 747-888-9747
  • Fax: 747-888-9747

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License NumberAO44430517
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: