Healthcare Provider Details

I. General information

NPI: 1427665686
Provider Name (Legal Business Name): JAMES BURKE
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/30/2020
Last Update Date: 06/20/2025
Certification Date: 06/20/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10877 CONDUCTOR BLVD STE 300
SUTTER CREEK CA
95685-9688
US

IV. Provider business mailing address

10877 CONDUCTOR BLVD STE 300
SUTTER CREEK CA
95685-9688
US

V. Phone/Fax

Practice location:
  • Phone: 209-223-6553
  • Fax:
Mailing address:
  • Phone: 530-409-5980
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code225400000X
TaxonomyRehabilitation Practitioner
License Number
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code175T00000X
TaxonomyPeer Specialist
License Number
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: