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NPI Code Detail

MEDICARE: JEFFRY BURKARD LCSW

MEDICARE: JEFFRY BURKARD 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 Worker51140TX

General Provider Information

NPI Number : 1760571756
Entity Type Code : Individual
Provider Name (Legal Business Name) : JEFFRY BURKARD LCSW
Provider Business Mailing Address
First Line : 7410 MISSION VALLEY RD
Second Line : VA HEALTHCARE CLINIC
City : SAN DIEGO
State : CA
Zip : 92108-4405
Country : US
Telephone Number : 619-497-8907
Fax Number : 619-497-8986
Provider Business Practice Location Address
First Line : 7410 MISSION VALLEY RD
Second Line : VA HEALTHCARE CLINIC
City : SAN DIEGO
State : CA
Zip : 92108-4405
Country : US
Telephone Number : 619-497-8907
Fax Number : 619-497-8986
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/11/2006
Last Update Date : 08/09/2016

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Directions to “ JEFFRY BURKARD LCSW” Practice Location

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