Provider Demographics
NPI:1427578202
Name:BURGOS, PEDRO JR (MSW, LCSW)
Entity Type:Individual
Prefix:MR
First Name:PEDRO
Middle Name:
Last Name:BURGOS
Suffix:JR
Gender:M
Credentials:MSW, LCSW
Other - Prefix:MR
Other - First Name:PETER
Other - Middle Name:
Other - Last Name:BURGOS
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:7725 LEEDS ST BLDG D
Mailing Address - Street 2:
Mailing Address - City:DOWNEY
Mailing Address - State:CA
Mailing Address - Zip Code:90242-3489
Mailing Address - Country:US
Mailing Address - Phone:562-215-5669
Mailing Address - Fax:562-279-1528
Practice Address - Street 1:7725 LEEDS ST BLDG D
Practice Address - Street 2:
Practice Address - City:DOWNEY
Practice Address - State:CA
Practice Address - Zip Code:90242-3489
Practice Address - Country:US
Practice Address - Phone:562-215-5669
Practice Address - Fax:562-279-1528
Is Sole Proprietor?:No
Enumeration Date:2017-06-22
Last Update Date:2022-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA83822101YM0800X
CA1079781041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health