Active NPI
Caitlin Rebecca Burgess
- Marriage & Family Therapist
- Santa Clara, CA
National Provider Identifier
1457788051
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Marriage & Family Therapist
- License
- 75080
- Practice address
- 1659 Scott Blvd Ste 30
Santa Clara, CA 95050-4137 - Phone
- (408) 244-1834
- NPI assigned
- Sep 27, 2013
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Marriage & Family Therapist | 106H00000X | 75080 | CA | Primary |
Addresses
Primary practice location
1659 Scott Blvd Ste 30
Santa Clara, CA 95050-4137
Mailing address
1659 Scott Blvd Ste 30
Santa Clara, CA 95050-4137
Phone (408) 244-1834
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Opted out of Medicare
- Yes, effective Jan 26, 2024 through Jan 26, 2028
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 75080 | CA | MD | Marriage & Family Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1380240000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1380240000000",
"number": "1457788051",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1659 SCOTT BLVD STE 30",
"city": "SANTA CLARA",
"state": "CA",
"postal_code": "950504137",
"telephone_number": "408-244-1834"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1659 SCOTT BLVD STE 30",
"city": "SANTA CLARA",
"state": "CA",
"postal_code": "950504137",
"telephone_number": "408-244-1834"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BURGESS",
"first_name": "CAITLIN",
"middle_name": "REBECCA",
"name_prefix": "Ms.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2013-09-27",
"last_updated": "2013-09-27",
"status": "A"
},
"taxonomies": [
{
"code": "106H00000X",
"taxonomy_group": "",
"desc": "Marriage & Family Therapist",
"state": "CA",
"license": "75080",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Santa Clara, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 27, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.