Jennifer E Burgos

Primary specialty

Marriage & Family TherapistTaxonomy code 106H00000X

License

122884 Issued in CA

Practice address

11712 Moorpark St Ste 101
Studio City, CA 91604-2155

Phone

(747) 205-0896

NPI assigned

Mar 8, 2025

Sex

Female

Sole proprietor

No

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

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Zeeva Behavioral Health, a Professional Licensed Clinical Soc

  • Clinical Social Worker
  • Los Angeles, CA
  • NPI 1821697632
  NPD

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

{
    "created_epoch": "1741392000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1741392000000",
    "number": "1245039858",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11712 MOORPARK ST STE 101",
            "city": "STUDIO CITY",
            "state": "CA",
            "postal_code": "916042155",
            "telephone_number": "651-226-2537"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11712 MOORPARK ST STE 101",
            "city": "STUDIO CITY",
            "state": "CA",
            "postal_code": "916042155",
            "telephone_number": "747-205-0896"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BURGOS",
        "first_name": "JENNIFER",
        "middle_name": "E",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-03-08",
        "last_updated": "2025-03-08",
        "certification_date": "2025-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "122884",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Bruce Vafa DDS, Inc.
• Bryce McDavitt PHD
• Elizabeth A Buckley, LMFT
• Mari Shone Bukofsky, M.F.T.
• Erica Buonora
• Merrilee Burke, LMFT
• Crystal Bustos
• Haleigh J Butler, LPCC
• Ellen M Butterfield, L.M.F.T.
• C. Draven Godwin Psychology

• Marriage & Family Therapist in Studio City, CA
• Providers in Studio City, CA by specialty
• Marriage & Family Therapist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 8, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.