# ANGEL BRIDGE, INC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1578635629
- **Authorized official:** DR. MARY JAYNE CARLSON-COLLINS PH.D. (OWNER)
- **Authorized official phone:** (805) 371-1679

## Contact information

- **Practice address:** 1414 E THOUSAND OAKS BLVD, \#103, THOUSAND OAKS, CA 91362-4401
- **Practice address phone:** (805) 371-1679
- **Mailing address:** 1414 E THOUSAND OAKS BLVD, \#103, THOUSAND OAKS, CA 91362-4401
- **Mailing address phone:** (805) 371-1679

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 106H00000X | Marriage & Family Therapist | MA14528 | CA | Yes |

## Other

- **Enumeration date:** 11/14/2006
- **Last updated:** 08/22/2020