MR. EDDIE REGINALD BURSTON II (NPI# 1376034348) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1376034348 |
| Entity Type | Individual |
| Full Name | MR. EDDIE REGINALD BURSTON II |
| Practice Address |
12727 Camino Emparrado San Diego CA 92128 |
| Mailing Address |
19612 Villa Ct Ehs7 Southfield MI 48076 |
| Practice Telephone | 8582659992 |
| Practice Fax Number | 8587985221 |
| Mailing Telephone | 8582659992 |
| Mailing Fax Number | 8587985221 |
| Enumeration Date | 2018-05-24 |
| Last Update Date | 2018-05-24 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 253Z00000X | In Home Supportive Care | B8163X | MI | Agencies |
| Y | 253Z00000X | In Home Supportive Care | 7516084757 | CA | Agencies |
| Street Address |
12727 CAMINO EMPARRADO |
| City | SAN DIEGO |
| State | CA |
| Zip Code | 92128 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1518585371 | Alicia Ford | Behavior Technician | 1170 Bernardo Plaza Court, Suite 350, San Diego, CA 92128 | 2020-07-08 |
| 1164087573 | Madeleine White | Dietitian, Registered | 16685 W Bernardo Dr, Suite 121, San Diego, CA 92128 | 2019-05-01 |
| 1053807677 | Joele Ghosn | Speech-Language Pathologist | 11838 Bernardo Plaza Ct #110, San Diego, CA 92128 | 2018-07-06 |
| 1336659218 | Ryan Fong | Physician Assistant | 15004 Innovation Drive (s97), San Diego, CA 92128 | 2017-10-05 |
| 1508316191 | Araceli Flores | Behavioral Analyst | 15737 Innovation Dr, Suite 200, San Diego, CA 92128 | 2016-10-07 |
| 1003283961 | Katherine Dishner | Hearing Instrument Specialist | 16766 Bernardo Center Dr Ste 206, San Diego, CA 92128 | 2015-08-27 |
| 1205212586 | Mobilia Dmd Inc. | Point of Service | 12405 Rancho Bernardo Rd., San Diego, CA 92128 | 2015-08-10 |
| 1346623634 | Angela Christine Storck-petersen | Dietitian, Registered | 11768 Caminito Corriente, San Diego, CA 92128 | 2015-07-04 |
| 1134526874 | Breeana Rose Lancaster | Speech-Language Pathologist | 11838 Bernardo Plaza Ct. Suite 110, Kids Therapy Associates, San Diego, CA 92128 | 2014-11-24 |
| 1730595570 | Charity Fluegge | Developmental Therapist | 11770 Bernardo Plaza Ct Ste 350, San Diego, CA 92128 | 2014-07-01 |
| Find all providers in zip 92128 | ||||
| Taxonomy Code | 253Z00000X |
| Grouping | Agencies |
| Classification | In Home Supportive Care |
| An In Home Supportive Care Agency provides services in the patient’s home with the goal of enabling the patient to remain at home. The services provided may include personal care services such as hands-on assistance with activities of daily living (ADLs), e.g., eating, bathing, dressing, and bladder and bowel requirements; homemaker services and instrumental activities of daily living (IADLs), e.g., taking medications, shopping for groceries, laundry, housekeeping, and companionship; and/or supervision or cuing so that a person can perform tasks themselves. |
| Notes: Source: National Uniform Claim Committee, 2008 [7/1/2008: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1437758000 | My Little Helpers LLC | In Home Supportive Care | 16959 Bernardo Center Dr Ste 104, San Diego, CA 92128-2554 | 2020-10-23 |
| 1598377871 | 360 Caregivers Home Agency LLC | In Home Supportive Care | 15870 Camino San Bernardo Apt 133, San Diego, CA 92127-2367 | 2020-08-19 |
| 1679184014 | Cdm Living Life, Inc. | In Home Supportive Care | 3665 Ruffin Rd Ste 100, San Diego, CA 92123-1871 | 2020-08-10 |
| 1013525955 | Compassionate In-home Care LLC | In Home Supportive Care | 4124 Via Candidiz Unit 142, San Diego, CA 92130-3159 | 2020-07-16 |
| 1073136487 | Jmjnt Corporation | In Home Supportive Care | 16766 Bernardo Center Dr Ste 200, San Diego, CA 92128-2502 | 2020-05-20 |
| 1750915591 | Elegant Legacy Home Care and Rehab LLC | In Home Supportive Care | 12180 Ragweed St, San Diego, CA 92129-4104 | 2020-03-02 |
| 1891325221 | Kevory Enterprises, Inc | In Home Supportive Care | 11722 Sorrento Valley Rd Ste G, San Diego, CA 92121-1021 | 2020-01-24 |
| 1295384279 | Brighter Life | In Home Supportive Care | 3125 Pasternack Pl, San Diego, CA 92123-3058 | 2019-09-11 |
| 1093368532 | Hisc 158 Inc | In Home Supportive Care | 8775 Aero Dr Ste 235, San Diego, CA 92123-1756 | 2019-07-23 |
| 1538712401 | First Meridian Care Services, Inc. | In Home Supportive Care | 4545 Murphy Canyon Rd Ste 204, San Diego, CA 92123-4363 | 2019-07-19 |
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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.