Provider Demographics
NPI:1932575776
Name:BURK-GARCIA, CHRISTINE ELISE (MSW)
Entity Type:Individual
Prefix:
First Name:CHRISTINE
Middle Name:ELISE
Last Name:BURK-GARCIA
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:CHRISTINE
Other - Middle Name:ELISE
Other - Last Name:BURK
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MSW
Mailing Address - Street 1:PO BOX 2087
Mailing Address - Street 2:
Mailing Address - City:MERCED
Mailing Address - State:CA
Mailing Address - Zip Code:95344-0087
Mailing Address - Country:US
Mailing Address - Phone:209-381-6800
Mailing Address - Fax:209-383-2203
Practice Address - Street 1:480 E 13TH ST
Practice Address - Street 2:
Practice Address - City:MERCED
Practice Address - State:CA
Practice Address - Zip Code:95341-6214
Practice Address - Country:US
Practice Address - Phone:209-381-6800
Practice Address - Fax:209-383-2203
Is Sole Proprietor?:No
Enumeration Date:2015-08-17
Last Update Date:2015-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAASW66086104100000X, 101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No104100000XBehavioral Health & Social Service ProvidersSocial Worker