Individual provider Active NPI

Cheryl Lane Burlingame, RN, MN, CNS

  • Adult Psychiatric/Mental Health Registered Nurse
  • Thousand Oaks, CA
National Provider Identifier
1760783443
Registry record updated Nov 10, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Psychiatric/Mental Health Registered NurseTaxonomy code 163WP0809X
License
306470 Issued in CA
Practice address
72 Moody CT
Suite 101
Thousand Oaks, CA 91360-6067
Phone
(805) 777-3500
NPI assigned
Nov 10, 2010
Last updated
Nov 10, 2010By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 10, 2010

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X P302 CA
Adult Psychiatric/Mental Health Registered Nurse 163WP0809X 306470 CA Primary

Addresses

Primary practice location

72 Moody CT
Suite 101
Thousand Oaks, CA 91360-6067

Mailing address

72 Moody CT
Suite 101
Thousand Oaks, CA 91360-6067
Phone (805) 777-3500

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
Credentials
Certified Nurse Specialist, Registered Nurse

State licenses

LicenseStateTypeSpecialty
P302CAMDMental Health Counselor

NPI Registry JSON

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

{
    "created_epoch": "1289347200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1289347200000",
    "number": "1760783443",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "72 MOODY CT",
            "address_2": "SUITE 101",
            "city": "THOUSAND OAKS",
            "state": "CA",
            "postal_code": "913606067",
            "telephone_number": "805-777-3500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "72 MOODY CT",
            "address_2": "SUITE 101",
            "city": "THOUSAND OAKS",
            "state": "CA",
            "postal_code": "913606067",
            "telephone_number": "805-777-3500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BURLINGAME",
        "first_name": "CHERYL",
        "middle_name": "LANE",
        "name_prefix": "Mrs.",
        "credential": "RN, MN, CNS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-11-10",
        "last_updated": "2010-11-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "CA",
            "license": "P302",
            "primary": false
        },
        {
            "code": "163WP0809X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Psychiatric/Mental Health, Adult",
            "state": "CA",
            "license": "306470",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Thousand Oaks, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 10, 2010; 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.