Organization
BRIDGE VISION LICENSED CLINICAL SOCIAL WORKER
Active
Organization
BRIDGE VISION LICENSED CLINICAL SOCIAL WORKER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
COLLEEN NOMSA CHALI PSYD, LCSW (CLINICAL DIRECTOR)
(909) 936-3888
Entity
Organization
Contact information
Practice address
357 W 2ND ST STE 3, SAN BERNARDINO, CA 92401-1803
(909) 936-3888
(909) 635-6173
Mailing address
255 N D ST, SUITE 401H, SAN BERNARDINO, CA 92401
(909) 936-3888
(909) 635-6173
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
LCSW29187
CA
Other
Enumeration date
04/29/2016
Last updated
10/18/2019
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