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NPI Code Detail

MEDICARE: MRS. KATHERINE BURKE PICA LCSW

MEDICARE: MRS. KATHERINE BURKE PICA 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 Worker27275CA

General Provider Information

NPI Number : 1194003616
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. KATHERINE BURKE PICA LCSW
Provider Business Mailing Address
First Line : 11956 BERNARDO PLAZA DR # 313
Second Line :
City : SAN DIEGO
State : CA
Zip : 92128-2538
Country : US
Telephone Number : 619-327-9317
Fax Number :
Provider Business Practice Location Address
First Line : 12396 WORLD TRADE DR STE 204
Second Line :
City : SAN DIEGO
State : CA
Zip : 92128-3789
Country : US
Telephone Number : 619-327-9317
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/01/2011
Last Update Date : 03/10/2023

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