Provider Demographics
NPI:1225233794
Name:BURKE, DANIEL J (LMFT)
Entity Type:Individual
Prefix:MR
First Name:DANIEL
Middle Name:J
Last Name:BURKE
Suffix:
Gender:M
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:841 MOHAWK ST
Mailing Address - Street 2:SUITE 250
Mailing Address - City:BAKERSFIELD
Mailing Address - State:CA
Mailing Address - Zip Code:93309-1506
Mailing Address - Country:US
Mailing Address - Phone:661-487-0940
Mailing Address - Fax:661-554-6222
Practice Address - Street 1:841 MOHAWK ST
Practice Address - Street 2:SUITE 250
Practice Address - City:BAKERSFIELD
Practice Address - State:CA
Practice Address - Zip Code:93309-1506
Practice Address - Country:US
Practice Address - Phone:661-487-0940
Practice Address - Fax:661-554-6222
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-15
Last Update Date:2017-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFC 41654106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAMFC 41654OtherLICENSED MFT