Edna C Burgos, ASW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

85597 Issued in CA

Practice address

823 Gateway Center Way
San Diego, CA 92102-4541

Phone

(619) 515-2300

NPI assigned

Oct 29, 2015

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Christie'S Place, Inc.

  • Clinic/Center
  • San Diego, CA
  • NPI 1033545066
  NPD (past)

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

{
    "created_epoch": "1446076800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1556150400000",
    "number": "1134591167",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2440 3RD AVE",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921011516",
            "telephone_number": "619-702-4186",
            "fax_number": "619-702-5924"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "823 GATEWAY CENTER WAY",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921024541",
            "telephone_number": "619-515-2300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BURGOS",
        "first_name": "EDNA",
        "middle_name": "C",
        "credential": "ASW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-10-29",
        "last_updated": "2019-04-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "CA",
            "license": "ASW35321",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "85597",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Johnathan Burgi
• Annmarie Burgo
• Andres Manuel Burgoin, B.A., RBT
• Amy Marie Burgos
• Araceli Burgos, BCBA
• Joana Burgos
• Julie Christina Burgos, DO
• Maritess Burgos
• Serena Burgos
• Adam Burgoyne, M.D., PH.D.

• Clinical Social Worker in San Diego, CA
• Providers in San Diego, CA by specialty
• Clinical Social Worker in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 25, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.