Burgess Psychological, Inc.

Primary specialty

Community/Behavioral Health AgencyTaxonomy code 251S00000X

License

PSY10843 Issued in CA

Legal business name

BURGESS PSYCHOLOGICAL, INC.

Practice address

1910 Huntington Dr
South Pasadena, CA 91030-4812

Phone

(626) 441-6111

Fax

(626) 441-6389

NPI assigned

Aug 24, 2010

Last updated

Aug 24, 2010By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Manny Burgess, PH.D.NPI 1013080290

Title

President

Phone

(626) 441-6111

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Locations

Practitioners 6

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Manny Burgess

  • Clinical Psychologist
  • South Pasadena, CA
  • NPI 1013080290
  Medicare reassignment Authorized official
• Dina Lynn Desanctis, MFT

  • Marriage & Family Therapist
  • South Pasadena, CA
  • NPI 1811076235
  NPD (past)
• Gerry Fagoaga, MFT

  • Marriage & Family Therapist
  • South Pasadena, CA
  • NPI 1912115106
  NPD (past)
• Judy Lee Ingoldsby, MA

  • Marriage & Family Therapist
  • South Pasadena, CA
  • NPI 1003093360
  NPD (past)
• Masano Seo Siu, LMFT

  • Marriage & Family Therapist
  • South Pasadena, CA
  • NPI 1790792471
  NPD (past)
• Mary McLeod Stoddard, PH.D.

  • Clinical Psychologist
  • South Pasadena, CA
  • NPI 1477741270
  NPD (past)

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

{
    "created_epoch": "1282608000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1282608000000",
    "number": "1801102132",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1910 HUNTINGTON DR",
            "city": "SOUTH PASADENA",
            "state": "CA",
            "postal_code": "910304812",
            "telephone_number": "626-441-6111",
            "fax_number": "626-441-6389"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1910 HUNTINGTON DR",
            "city": "SOUTH PASADENA",
            "state": "CA",
            "postal_code": "910304812",
            "telephone_number": "626-441-6111",
            "fax_number": "626-441-6389"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BURGESS PSYCHOLOGICAL, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-08-24",
        "last_updated": "2010-08-24",
        "status": "A",
        "authorized_official_last_name": "BURGESS",
        "authorized_official_first_name": "MANNY",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "626-441-6111",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PH.D."
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "CA",
            "license": "PSY10843",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Analisa Bublitz
• Jennifer Buchanan, CNM, WHNP-BC, IBCLC
• Pilar Buelna
• Yanel Larysa Bueno
• Antonio Ramos Bugarin
• Manny Burgess
• Celest Bydon Navarette
• Timothy Byun
• Janette Segovia Cabalinan, D.D.S.
• Olivia Marie Cabo

• Community/Behavioral Health Agency in South Pasadena, CA
• Providers in South Pasadena, CA by specialty
• Community/Behavioral Health Agency in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 24, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.