Organization
BRIDGMAN PSYCHOLOGICAL SERVICES, P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. LAIRD BRIDGMAN PSY.D. (PRESIDENT)
(949) 707-6633
Entity
Organization
Contact information
Practice address
22792 CENTRE DR STE 290, LAKE FOREST, CA 92630-6304
(949) 707-6633
(949) 770-5433
Mailing address
22792 CENTRE DR STE 290, LAKE FOREST, CA 92630-6304
(949) 707-6633
(949) 770-5433
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
PSY14510
CA
106H00000X
Marriage & Family Therapist
MFC28928
CA
Other
Enumeration date
05/14/2008
Last updated
05/14/2008
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