Individual provider Active NPI

Jeffrey Burkholder

  • Administrator Registered Nurse
  • Irvine, CA
National Provider Identifier
1093626590
Registry record updated Sep 14, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Administrator Registered NurseTaxonomy code 163WA2000X
License
784263 Issued in CA
Practice address
6640 Alton Pkwy
Irvine, CA 92618-3734
Phone
(949) 932-2863
NPI assigned
Sep 14, 2026
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 14, 2026

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Administrator Registered Nurse 163WA2000X 784263 CA Primary

Addresses

Primary practice location

6640 Alton Pkwy
Irvine, CA 92618-3734

Mailing address

410 Shea LN
Long Beach, CA 90803-2041
Phone (949) 932-2863

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1789344000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1789344000000",
    "number": "1093626590",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "410 SHEA LN",
            "city": "LONG BEACH",
            "state": "CA",
            "postal_code": "908032041",
            "telephone_number": "949-932-2863"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6640 ALTON PKWY",
            "city": "IRVINE",
            "state": "CA",
            "postal_code": "926183734",
            "telephone_number": "949-932-2863"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BURKHOLDER",
        "first_name": "JEFFREY",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2026-09-14",
        "last_updated": "2026-09-14",
        "certification_date": "2026-09-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WA2000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Administrator",
            "state": "CA",
            "license": "784263",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Irvine, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 14, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.

Verify at the official NPI Registry.