Provider Demographics
NPI:1942061858
Name:BURKA, JANE BELLE (PHD)
Entity Type:Individual
Prefix:
First Name:JANE
Middle Name:BELLE
Last Name:BURKA
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5655 COLLEGE AVE STE 315D
Mailing Address - Street 2:
Mailing Address - City:OAKLAND
Mailing Address - State:CA
Mailing Address - Zip Code:94618-1669
Mailing Address - Country:US
Mailing Address - Phone:510-847-3176
Mailing Address - Fax:
Practice Address - Street 1:5655 COLLEGE AVE STE 315D
Practice Address - Street 2:
Practice Address - City:OAKLAND
Practice Address - State:CA
Practice Address - Zip Code:94618-1669
Practice Address - Country:US
Practice Address - Phone:510-847-3176
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-01-17
Last Update Date:2024-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY6410103TP0814X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TP0814XBehavioral Health & Social Service ProvidersPsychologistPsychoanalysis