Manny Burgess
NPI 1013080290ActiveIndividual· Psychologist, Clinical· South Pasadena, CA
Psychologist, Clinical in South Pasadena, California, licensed in CA, with an NPI issued in November 2006. Enrolled in Medicare as practitioner - clinical psychologist.
Overview
| NPI | 1013080290 |
|---|---|
| Status | Active |
| Entity type | Individual |
| Sole proprietor | Yes |
| NPI issued | Nov 16, 2006 |
| Last updated in NPPES | Jul 8, 2007 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Psychologist, Clinical Primary | 103TC0700X | PSY10843 | CA |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Nov 10, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 11, 2026 | No match | — |
| New York OMIG · Nov 11, 2026 | No match | — |
| Ohio Medicaid · Nov 11, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 11, 2026 | No match | — |
| Washington HCA · Nov 11, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Enrolled Practitioner - Clinical Psychologist (CA) |
|---|
Education and affiliations
| Graduation year | 1986 |
|---|---|
| Medicare specialty | Clinical Psychologist |
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