1609436534 NPI number — BRIDGES FAMILY THERAPY INC

Table of content: (NPI 1609436534)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1609436534 NPI number — BRIDGES FAMILY THERAPY INC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
BRIDGES FAMILY THERAPY INC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
6
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1609436534
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
07/10/2023
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
226 W OJAI AVE., SUITE 101-180
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
OJAI
Provider Business Mailing Address State Name:
CA
Provider Business Mailing Address Postal Code:
93023-3277
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
805-798-3150
Provider Business Mailing Address Fax Number:
805-232-3224

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
509 N MONTGOMERY STREET
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
OJAI
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
93023
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
805-798-3150
Provider Business Practice Location Address Fax Number:
805-232-3224
Provider Enumeration Date:
06/13/2019

Additional Information

Authorized Official

Authorized Official Last Name:
ANDERSON
Authorized Official First Name:
PATRICIA
Authorized Official Middle Name:
Authorized Official Title or Position:
CEO
Authorized Official Telephone Number:
805-798-0739

Provider Taxonomy Codes

  • Taxonomy code: 106H00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 1041C0700X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 1366081986 . This is a "LMFT" identifier , issued by the state of ( CA ) . This identifiers is of the category "OTHER".
  • Identifier: 1346876679 . This is a "LMFT" identifier , issued by the state of ( CA ) . This identifiers is of the category "OTHER".
  • Identifier: 1386011047 . This is a "LMFT" identifier , issued by the state of ( CA ) . This identifiers is of the category "OTHER".
  • Identifier: 1811469349 . This is a "LMFT" identifier , issued by the state of ( CA ) . This identifiers is of the category "OTHER".
  • Identifier: 1194264838 . This is a "LMFT" identifier , issued by the state of ( CA ) . This identifiers is of the category "OTHER".
  • Identifier: 1225343668 . This is a "LMFT" identifier , issued by the state of ( CA ) . This identifiers is of the category "OTHER".
  • Identifier: 1336207257 . This is a "LMFT" identifier , issued by the state of ( CA ) . This identifiers is of the category "OTHER".
  • Identifier: 1457821522 . This is a "LMFT" identifier , issued by the state of ( CA ) . This identifiers is of the category "OTHER".
  • Identifier: 1093901779 . This is a "LMFT" identifier , issued by the state of ( CA ) . This identifiers is of the category "OTHER".
  • Identifier: 1700038411 . This is a "LMFT" identifier , issued by the state of ( CA ) . This identifiers is of the category "OTHER".




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