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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