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Organization
BRIDGE ACADEMY COLLECTIVE
Active
Organization
BRIDGE ACADEMY COLLECTIVE
Active
Other names
The Bridge Academy Collective, The Bridge Advocacy and Counseling
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JACQUELINE MICHELE MACK-HARRIS LMFT, PSYD (FOUNDER/CLINICAL DIRECTOR)
(949) 275-2979
Entity
Organization
Contact information
Practice address
2904 BREA BLVD, FULLERTON, CA 92835-2015
(951) 805-3467
(951) 356-7325
Mailing address
19917 CRESTWOOD DR, LAKE ELSINORE, CA 92530-0400
(949) 275-2979
(951) 356-7325
Taxonomy
Speciality
Code
Description
License number
State
106H00000X
Marriage & Family Therapist
—
—
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
—
—
Other
Enumeration date
01/22/2024
Last updated
08/30/2024
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