| Heather Burdine, | |
|
15161 Jackson St, Midway City, CA 92655-1432 | |
| (949) 273-0555 | |
| Not Available |
| Full Name | Heather Burdine |
|---|---|
| Gender | Female |
| Speciality | Social Worker - Clinical |
| Location | 15161 Jackson St, Midway City, California |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1487169744 | NPI | - | NPPES |
| 76204 | Other | CA | BBS |
| 76204 | Other | CA | ACSW |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | 76204 (California) | Primary |
| Entity Name | Sud Specialty Group - Ca |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1972138238 PECOS PAC ID: 9537534177 Enrollment ID: O20230412001370 |
| Mailing Address | Practice Location Address |
|---|---|
| Heather Burdine, 15161 Jackson St, Midway City, CA 92655-1432 Ph: (949) 273-0555 | Heather Burdine, 15161 Jackson St, Midway City, CA 92655-1432 Ph: (949) 273-0555 |
Humera Sheikh, ACSW Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 15161 Jackson St, Midway City, CA 92655 Phone: 949-273-0555 Fax: 888-517-7123 | |
Blanca Patricia Hernandez, Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 15161 Jackson St, Midway City, CA 92655 Phone: 562-309-3689 | |
Ariel Donley, Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 15161 Jackson St, Midway City, CA 92655 Phone: 949-378-6154 |