Jacob Burroughs

Primary specialty

Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X

Practice address

4150 Clement Street
BLDG. 200 1St Floor, Room 1D-007
San Francisco, CA 94121

Phone

(415) 221-4810

NPI assigned

Feb 23, 2023

Last updated

Mar 11, 2023By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1677110400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678492800000",
    "number": "1184323602",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1258 BURNS RD",
            "city": "RADCLIFF",
            "state": "KY",
            "postal_code": "401609307",
            "telephone_number": "270-272-8863"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4150 CLEMENT STREET",
            "address_2": "BLDG. 200 1ST FLOOR, ROOM 1D-007",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "94121",
            "telephone_number": "415-221-4810"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BURROUGHS",
        "first_name": "JACOB",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2023-02-23",
        "last_updated": "2023-03-11",
        "certification_date": "2023-03-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Glenda L. Burr, PSY D.
• Kasandra Burr, M.A., MFT
• Floyd Dupree Burrell, RAS
• Greg Burrell, M.D.
• Brenda Hamel Burris, MSW, LCSW
• Whitney Burroughs, NP
• Penelope Jo Burrows, M.F.T.
• Barry Burstein, DDS
• Burt Center, Inc
• Burt Childrens Center

• Student in an Organized Health Care Education/Training Program in San Francisco, CA
• Providers in San Francisco, CA by specialty
• Student in an Organized Health Care Education/Training Program in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 11, 2023; 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.