MEDICARE: KIMBERLY BURDEEN

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number State
1	171M00000X	Case Manager/Care Coordinator
2	373H00000X	Day Training/Habilitation Specialist
3	373H00000X	Day Training/Habilitation Specialist	CA
4	225400000X	Rehabilitation Practitioner	CA

General Provider Information

NPI Number	:	1891503140
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KIMBERLY BURDEEN

Provider Business Mailing Address
First Line	:	170 9TH ST
Second Line	:
City	:	SAN FRANCISCO
State	:	CA
Zip	:	94103-2603
Country	:	US
Telephone Number	:	925-595-7861
Fax Number	:

Provider Business Practice Location Address
First Line	:	1157 VALENCIA ST
Second Line	:
City	:	SAN FRANCISCO
State	:	CA
Zip	:	94110-3077
Country	:	US
Telephone Number	:	415-777-0333
Fax Number	:

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

Provider Enumeration Date	:	12/19/2024
Last Update Date	:	08/06/2025

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Directions to “ KIMBERLY BURDEEN ” Practice Location

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