Individual provider Active NPI

Jeffery Burke

  • Rehabilitation Practitioner
  • Riverside, CA
National Provider Identifier
1568023877
Registry record updated Nov 5, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rehabilitation PractitionerTaxonomy code 225400000X
License
AII31190619 Issued in CA
Practice address
2085 Rustin Ave BLDG 1
Riverside, CA 92507-2498
Phone
(951) 715-5040
NPI assigned
Jun 26, 2019
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 5, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Rehabilitation Practitioner 225400000X AII31190619 CA Primary
Mental Health Counselor 101YM0800X AII31190619 CA
Addiction (Substance Use Disorder) Counselor 101YA0400X AII31190619 CA

Addresses

Primary practice location

2085 Rustin Ave BLDG 1
Riverside, CA 92507-2498

Mailing address

4144 Cedar St
Riverside, CA 92501-3445
Phone (516) 622-2584

Other practice location 1

1963 N E St
San Bernardino, CA 92405-3919
Phone (909) 881-6146

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
AII31190619CAMDAddiction (Substance Use Disorder) Counselor

NPI Registry JSON

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

{
    "created_epoch": "1561507200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1762300800000",
    "number": "1568023877",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4144 CEDAR ST",
            "city": "RIVERSIDE",
            "state": "CA",
            "postal_code": "925013445",
            "telephone_number": "516-622-2584"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2085 RUSTIN AVE BLDG 1",
            "city": "RIVERSIDE",
            "state": "CA",
            "postal_code": "925072498",
            "telephone_number": "951-715-5040"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1963 N E St",
            "address_purpose": "LOCATION",
            "city": "San Bernardino",
            "state": "CA",
            "postal_code": "924053919",
            "country_code": "US",
            "telephone_number": "909-881-6146",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BURKE",
        "first_name": "JEFFERY",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-06-26",
        "last_updated": "2025-11-05",
        "certification_date": "2025-11-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225400000X",
            "taxonomy_group": "",
            "desc": "Rehabilitation Practitioner",
            "state": "CA",
            "license": "AII31190619",
            "primary": true
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "CA",
            "license": "AII31190619",
            "primary": false
        },
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "CA",
            "license": "AII31190619",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Riverside, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 5, 2025; 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.