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General NPI Number Information
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NPI Number | 1194003616
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Entity Type | Individual
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Provider Name | KATHERINE BURKE PICA LCSW
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Gender | Female
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Dates
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Enumeration Date | 08/01/2011
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Last Update Date | 03/10/2023
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Provider Practice Location Address
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Address Line | 12396 WORLD TRADE DR STE 204
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City | SAN DIEGO
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State | CA
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Zip | 92128-3789
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Country | US
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Telephone | 619-327-9317
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Fax |
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Provider Business Mailing Address
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Address Line | 11956 BERNARDO PLAZA DR # 313
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City | SAN DIEGO
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State | CA
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Zip | 92128-2538
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Country | US
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Telephone | 619-327-9317
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 27275
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License Number State | CA
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