Jeffrey Keith Bridges in Santa Rosa - Clinical
Jeffrey Keith Bridges - NPI 1750431490
Jeffrey Keith Bridges is a Clinical in Santa Rosa, California. Jeffrey Keith Bridges practices all healthcare services and medical treatments related to Clinical. The NPI Number for Jeffrey Keith Bridges is 1750431490. The last update date is 2007-07-27.
Jeffrey Keith Bridges's current location address is 576 B St, Santa Rosa, California. You can contact this provider via phone number 7075465327. The mailing address for Jeffrey Keith Bridges is 576 B St, Santa Rosa, California. To know further, please read the information below!
Provider Profile Detail
| Provider Name | Jeffrey Keith Bridges |
|---|---|
| Address | 576 B St, Santa Rosa, California |
| Phone Number | 7075465327 |
| Fax Number | |
| Sole Proprietor | Y |
| Credentials | PH.D. |
NPI Number Detail
| NPI Number | 1750431490 |
|---|---|
| Provider Enumeration Date | 2007-01-12 |
| Last Updated Date | 2007-07-27 |
Provider Mailing Address Detail
| Address | 576 B St |
|---|---|
| City | Santa Rosa |
| State | California (CA) |
| Post Code | 954015269 |
| Phone Number | 7075465327 |
| Fax Number |
Provider's Primary Taxonomy Detail
| Speciality | Clinical |
|---|---|
| Taxonomy | 103Tc0700X |
| Licence No | PSY11129 |
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Definition: A psychologist who provides continuing and comprehensive mental and behavioral health care for individuals and families; consultation to agencies and communities; training, education and supervision; and research-based practice. It is a specialty in |
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Provider's Other Legacy Identifiers
| Identifier | Identifier Type | Identifier State | Identifier Issuer |
|---|---|---|---|
| 74148 | CA | MHN PROVIDER # | |
| 156248 | CA | VALUEOPTIONS PROV NUM | |
| OPL111290 | CA | BLUE SHIELD PROV # |
Post Comment/ Review Below
What is the unique provider identifier assigned to Jeffrey Keith Bridges?
The Jeffrey Keith Bridges has been issued the NPI (National Provider Identifier) 1750431490 by the Centers for Medicare & Medicaid Services (CMS). This 10-digit code is a unique identification number for healthcare providers.
Could you please provide the complete street address where Jeffrey Keith Bridges is physically located?
The Jeffrey Keith Bridges is physically situated at the following address: 576 B St, Santa Rosa, CA, 954015269.
What is the Jeffrey Keith Bridges's area of specialization and corresponding taxonomy classification?
The Jeffrey Keith Bridges's specialty field is Clinical, and it falls under the taxonomy code 103Tc0700X, which categorizes healthcare providers based on their specialties.
On what date did the Centers for Medicare & Medicaid Services issue the 1750431490 to Jeffrey Keith Bridges?
The Jeffrey Keith Bridges received its 1750431490 assignment from the Centers for Medicare & Medicaid Services on 2007-01-12.
As of what date was the information regarding Jeffrey Keith Bridges, such as address, specialty, and other details, last verified and confirmed to be up-to-date?
The information related to Jeffrey Keith Bridges, including its address, specialty, and other relevant details, was last verified and confirmed to be up-to-date on 2007-07-27.