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Individual
DR. JEFFREY KEITH BRIDGES
Active
Individual
DR. JEFFREY KEITH BRIDGES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PH.D.
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
PSY11129
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
074148
MHN PROVIDER #
CA
01
—
156248
VALUEOPTIONS PROV NUM
CA
01
—
OPL111290
BLUE SHIELD PROV #
CA
Enumeration date
01/12/2007
Last updated
07/27/2007
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