Provider Demographics
NPI:1932752490
Name:BURKE, EAMON F
Entity Type:Individual
Prefix:
First Name:EAMON
Middle Name:F
Last Name:BURKE
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:REBEKAH CHILDREN SERVICES
Mailing Address - Street 2:290 IOOF AVE.
Mailing Address - City:GILROY
Mailing Address - State:CA
Mailing Address - Zip Code:95020
Mailing Address - Country:US
Mailing Address - Phone:408-846-2100
Mailing Address - Fax:408-842-8815
Practice Address - Street 1:REBEKAH CHILDREN SERVICES
Practice Address - Street 2:290 IOOF AVE.
Practice Address - City:GILROY
Practice Address - State:CA
Practice Address - Zip Code:95020
Practice Address - Country:US
Practice Address - Phone:408-846-2100
Practice Address - Fax:408-842-8815
Is Sole Proprietor?:No
Enumeration Date:2019-07-23
Last Update Date:2020-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
No101Y00000XBehavioral Health & Social Service ProvidersCounselor
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No171M00000XOther Service ProvidersCase Manager/Care Coordinator