Joanna Isabel Burga
Individual provider Active NPI Clinical Social Worker · Venice, CA
NPI 1245879337 · NPPES record last updated Jan 6, 2020
Key facts
- NPI
- 1245879337
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Clinical Social Worker 1041C0700X
- License
- 87916 (CA)
- Practice address
- 622 Rose Ave
Venice, CA 90291-2767 - Phone
- (310) 392-8636
- NPI assigned
- Jan 6, 2020
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 2
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: No · DME: Yes · Home health: No · Power mobility devices: No · Hospice: No
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 87916 | CA | MD | Marriage & Family Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Venice Family Clinic | Current |
Accepting new patients | |
| Venice Family Clinic | Current |
Accepting new patients |
Locations
622 Rose Ave
Venice, CA 90291
Phone (310) 664-7941
604 Rose Ave
Venice, CA 90291
Phone (310) 392-8630
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 87916 | CA | Yes |
Addresses
Primary practice location
622 Rose Ave
Venice, CA 90291-2767
Mailing address
622 Rose Ave
Venice, CA 90291-2767
Other providers in Venice, CA
- Diana Brown
- Vivian Brown
- Jessica Dian Bryant
- Btka
- Cindy Bugarin
- Amanda Burns
- David Huw Burston
- Joana Bustamante
- Eva Butler
- Sergio L Cacciotti
All providers in Venice, CA · Clinical Social Worker in California
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 6, 2020. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.