Katharine Burgess

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

79590 Issued in CA

Practice address

2330 Vanguard Way Apt Q106
Costa Mesa, CA 92626-6583

Phone

(562) 810-6277

NPI assigned

May 21, 2020

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Katharine Takeshita Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1590019200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1590019200000",
    "number": "1902429194",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2330 VANGUARD WAY APT Q106",
            "city": "COSTA MESA",
            "state": "CA",
            "postal_code": "926266583"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2330 VANGUARD WAY APT Q106",
            "city": "COSTA MESA",
            "state": "CA",
            "postal_code": "926266583",
            "telephone_number": "562-810-6277"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BURGESS",
        "first_name": "KATHARINE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-05-21",
        "last_updated": "2020-05-21",
        "certification_date": "2020-05-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "79590",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KATHARINE",
            "last_name": "TAKESHITA",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Rebecca Ann Bukucs
• Venus Bulandus
• Jessica Bunkis
• Dustin James Burcombe
• Kristina Burger, DO
• Christopher Burkett, P.A.
• Zein Burkett
• Makayla Burkley
• Elise Burlace
• Sarah Burley

• Clinical Social Worker in Costa Mesa, CA
• Providers in Costa Mesa, CA by specialty
• Clinical Social Worker in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 21, 2020; 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.