Individual provider Active NPI

Karen Schoenfeld Burkhart, PH.D.

  • Clinical Psychologist
  • Fairfield, CA
National Provider Identifier
1992924070
Registry record updated Mar 24, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
PSY 15075 Issued in CA
Practice address
420 Executive CT N Ste a
Fairfield, CA 94534-1464
Phone
(077) 646-2988
NPI assigned
Apr 25, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 24, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X PSY 15075 CA Primary

Addresses

Primary practice location

420 Executive CT N Ste a
Fairfield, CA 94534-1464

Mailing address

420 Executive CT N Ste a
Fairfield, CA 94534-1464
Phone (707) 646-2988

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230621001417 AZ Practitioner - Clinical Psychologist 1557729787 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
PSY 15075CAMDClinical Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Mountain Park Health Center CurrentSince Jun 5, 2023 Accepting new patients
Mountain Park Health Center CurrentSince Jun 5, 2023 Accepting new patients
Mountain Park Health Center Current Accepting new patients

Locations

635 E Baseline Rd
Phoenix, AZ 85042

3003 N Central Ave
Ste 1600
Phoenix, AZ 85012
Phone (602) 323-3492

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1177459200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1679616000000",
    "number": "1992924070",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "420 EXECUTIVE CT N STE A",
            "city": "FAIRFIELD",
            "state": "CA",
            "postal_code": "945341464",
            "telephone_number": "707-646-2988"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "420 EXECUTIVE CT N STE A",
            "city": "FAIRFIELD",
            "state": "CA",
            "postal_code": "945341464",
            "telephone_number": "077-646-2988"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BURKHART",
        "first_name": "KAREN",
        "middle_name": "SCHOENFELD",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-04-25",
        "last_updated": "2023-03-24",
        "certification_date": "2023-03-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CA",
            "license": "PSY 15075",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fairfield, CA

Sources for this page

Verify at the official NPI Registry.