MEDICARE: SUSAN BURKE

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
1	101YA0400X	Addiction (Substance Use Disorder) Counselor

General Provider Information

NPI Number	:	1457215907
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SUSAN BURKE

Provider Business Mailing Address
First Line	:	12070 TELEGRAPH RD
Second Line	:
City	:	SANTA FE SPRINGS
State	:	CA
Zip	:	90670-3771
Country	:	US
Telephone Number	:	562-777-7500
Fax Number	:

Provider Business Practice Location Address
First Line	:	1092 NEW YORK DR
Second Line	:
City	:	ALTADENA
State	:	CA
Zip	:	91001-3118
Country	:	US
Telephone Number	:	626-421-6031
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/10/2025
Last Update Date	:	12/10/2025

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Directions to “ SUSAN BURKE ” Practice Location

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