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Recently Updated NPI Information — some details in this NPI profile have been updated in the NPI registry within the last 60 days.

VICMAR BURGONIO FNP
NPI 1710604525
Nurse Practitioner - Family in Long Beach, CA

Active since October 24, 2022
3620 LONG BEACH BLVD STE C3, LONG BEACH, CA 90807(661) 313-2166 Get Directions Write a Review

NPPES record last updated: August 12, 2026. Verified against the NPPES registry weekly; last sync: August 23, 2026.

Record update history: Aug 12, 2026, Aug 6, 2026, Jul 7, 2026 and 2 more (5 updates tracked since 2022).

About Vicmar Burgonio Fnp NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

VICMAR BURGONIO FNP (NPI 1710604525) is an individual family provider in Long Beach, California, licensed in California (NP95022430) and active in the NPI registry since October 2022. He maintains a secondary practice location in Anaheim.

NPPES Registry Identity

NPI1710604525
Entity TypeIndividualMale
Primary Taxonomy363LF0000X
Provider Legal NameVICMAR BURGONIOCredential: FNP
Location Address3620 LONG BEACH BLVD STE C3Long Beach, CA 90807-6009
Mailing Address4330 E Miraloma AveAnaheim, CA 92807-1886
Phone(661) 313-2166
Sole ProprietorYes
Enumeration DateOctober 24, 2022
Last NPPES UpdateAugust 12, 20265 updates tracked since enumeration
NPPES CertifiedAugust 12, 2026
✔ NPI 1710604525 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyNurse Practitioner · FamilyPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363LF0000X
License✔ Licensed in CA · NP95022430
Also ListedNurse Practitioner · Psychiatric/Mental HealthTaxonomy 363LP0808X · License NP95022430 (CA)
3620 LONG BEACH BLVD STE C3, Long Beach, CA 90807
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Secondary Practice Location 1

Location 14330 E Miraloma AveAnaheim, CA 92807-1886 · Phone (800) 464-4000

Other Providers at the Same Location NPPES 3

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

DUFFY & KANG PSYCHOLOGY INC.D/B/A WEAVING CLARITY
Psychologist (Counseling)
3620 LONG BEACH BLVD STE C3
LONG BEACH, CA 90807
Los Angeles County (213) 364-6800
GUIDED STEPS COUNSELING
Social Worker (Clinical)
3620 LONG BEACH BLVD STE C3
LONG BEACH, CA 90807
Los Angeles County (424) 488-3712
KAYLA ANH THU NGUYEN AMFT
Counselor (Mental Health)
3620 LONG BEACH BLVD STE C3
LONG BEACH, CA 90807
Los Angeles County (818) 451-5026

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Vicmar Burgonio's NPI number?

The NPI number for Vicmar Burgonio is 1710604525. It was assigned to this individual provider in the NPPES registry on October 24, 2022.

Where is Vicmar Burgonio located?

Vicmar Burgonio practices at 3620 Long Beach Blvd Ste C3, Long Beach, CA 90807. The listed phone number is (661) 313-2166.

What is Vicmar Burgonio's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Family, with taxonomy code 363LF0000X.

When was this NPI record last updated?

The NPPES record for Vicmar Burgonio was last updated on August 12, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 18 days ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.