MS. ATHENA M. BURNSIDE (NPI# 1023581196) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1023581196 |
| Entity Type | Individual |
| Full Name | MS. ATHENA M. BURNSIDE |
| Practice Address |
2600 S El Camino Real Ste 200 San Mateo CA 94403-2382 |
| Practice Telephone | 6503724080 |
| Practice Fax Number | 6504009662 |
| Mailing Telephone | 6505788691 |
| Enumeration Date | 2019-01-10 |
| Last Update Date | 2019-04-23 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QM0850X |
Clinic/Center Specialization: Adult Mental Health |
Ambulatory Health Care Facilities |
| Street Address |
2600 S EL CAMINO REAL STE 200 |
| City | SAN MATEO |
| State | CA |
| Zip Code | 94403-2382 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1730469198 | Ann K Rawley | Psychologist | 2600 S El Camino Real Ste 200, San Mateo, CA 94403-2382 | 2011-08-17 |
| 1396344990 | Karis Sykes | Counselor | 2600 S El Camino Real Ste 200, San Mateo, CA 94403-2382 | 2020-10-23 |
| 1467067058 | Jennifer Amanda Gross | Marriage & Family Therapist | 2600 S El Camino Real Ste 200, San Mateo, CA 94403-2382 | 2020-09-10 |
| 1710590088 | Caminar | Community/Behavioral Health | 2600 S El Camino Real Ste 200, San Mateo, CA 94403-2382 | 2020-08-26 |
| 1639792039 | Alshwenbear Campos | Counselor | 2600 S El Camino Real Ste 200, San Mateo, CA 94403-2382 | 2020-05-20 |
| 1346861465 | Nadrina Weseman | Case Manager/Care Coordinator | 2600 S El Camino Real Ste 200, San Mateo, CA 94403-2382 | 2020-04-29 |
| 1952921975 | Anna Dukovic | Counselor | 2600 S El Camino Real Ste 200, San Mateo, CA 94403-2382 | 2020-04-20 |
| 1992334445 | Zuleyma Zirate | Case Manager/Care Coordinator | 2600 S El Camino Real Ste 200, San Mateo, CA 94403-2382 | 2020-04-06 |
| 1134755713 | Nuha Mahmoud Ghanem | Case Manager/Care Coordinator | 2600 S El Camino Real Ste 200, San Mateo, CA 94403-2382 | 2020-03-16 |
| 1255971826 | Seungchan Suh | Case Manager/Care Coordinator | 2600 S El Camino Real Ste 200, San Mateo, CA 94403-2382 | 2020-01-13 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1710520903 | Happy Enerqi LLC | Acupuncturist | 5 43rd Ave, San Mateo, CA 94403 | 2019-10-21 |
| 1740840396 | Vincent Wing Ching Fong | Marriage & Family Therapist | 2600 S. El Camino Real Suite 200, San Mateo, CA 94403 | 2019-06-17 |
| 1861056426 | Denise Gaytan | Licensed Vocational Nurse | 2600 El Camino, San Mateo, CA 94403 | 2019-04-29 |
| 1134686991 | Connie Markoff | Counselor | 3827 Fernwood St, San Mateo, CA 94403 | 2019-02-27 |
| 1467965392 | Happyqi Inc | Acupuncturist | 5 43rd Ave., San Mateo, CA 94403 | 2017-11-14 |
| 1710403092 | John Luu | Chiropractor | 3153 Campus Dr, San Mateo, CA 94403 | 2017-08-17 |
| 1477009033 | Latifunisa Lilani | Community Health Worker | 2600 El Camino Real, San Mateo, CA 94403 | 2016-09-01 |
| 1881029874 | Juan Carlos Friesen | Licensed Vocational Nurse | 2600 S. El Camino, Suite #200, San Mateo, CA 94403 | 2013-09-09 |
| 1619300423 | Emily Rodda | Nurse Practitioner | 222 W. 39th Avenue, San Mateo Medical Center - Pediatric Clinic, San Mateo, CA 94403 | 2013-08-15 |
| 1619309549 | Maria Lucila Echeverria-bustios | Counselor | 1911 Ivy St., San Mateo, CA 94403 | 2013-08-02 |
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| Taxonomy Code | 261QM0850X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Adult Mental Health |
| An entity, facility, or distinct part of a facility providing diagnostic, treatment, and prescriptive services related to mental and behavioral disorders in adults. |
| Notes: [7/1/2003: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1003145657 | Caminar | Clinic/Center | 2600 S El Camino Real Ste 100, San Mateo, CA 94403 | 2009-12-10 |
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| 1972112712 | County of Kern | Clinic/Center | 316 Kentucky, Bakersfield, CA 93305 | 2020-07-28 |
| 1417566605 | Freedom Family Counseling Group Corp. | Clinic/Center | 190 S Orchard Ave Ste C230, Vacaville, CA 95688-3657 | 2020-07-23 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.