MEDICARE: BRIDGEWELL CARE LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	251B00000X	Case Management Agency
2	251S00000X	Community/Behavioral Health Agency

General Provider Information

NPI Number	:	1124969761
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BRIDGEWELL CARE LLC

Provider Business Mailing Address
First Line	:	5185 MADDALENA PL
Second Line	:
City	:	FAIRFIELD
State	:	CA
Zip	:	94534-6740
Country	:	US
Telephone Number	:	415-307-2853
Fax Number	:

Provider Business Practice Location Address
First Line	:	1700 HEMLOCK ST
Second Line	:
City	:	FAIRFIELD
State	:	CA
Zip	:	94533-3718
Country	:	US
Telephone Number	:	415-307-2853
Fax Number	:

Authorized Official
Title or Position	:	CO-CEO
Name	:	MR. MANOJ PARVATANENI
Credential	:	NOTHING MEDICAL
Telephone Number	:	415-307-2853

Provider Enumeration Date	:	04/06/2026
Last Update Date	:	04/06/2026

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Directions to “BRIDGEWELL CARE LLC ” Practice Location

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