Nicole Burgess
Counselor in San Jose, CA. Individual provider (NPI-1).
NPI number1164057402
StatusActive
Last updated in NPPESMar 6, 2020
Details
- NPI
- 1164057402
- Entity type
- Individual (NPI-1)
- Name
- Nicole Burgess
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Mar 6, 2020
- Certification date
- Mar 6, 2020
- Last updated
- Mar 6, 2020
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 101Y00000X | Counselor | – | – | Yes |
Practice location
2625 Zanker Rd Ste 101San Jose, CA 95134-2130
Phone 408-325-5211
Mailing address
500 El Camino RealSanta Clara, CA 95053-1000
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