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NPI Code Detail

MEDICARE: BRIDGET SMITH M.S.

MEDICARE:   BRIDGET  SMITH  M.S.
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
1101YM0800XMental Health Counselor49238CA

General Provider Information

NPI Number : 1891973319
Entity Type Code : Individual
Provider Name (Legal Business Name) : BRIDGET SMITH M.S.
Provider Business Mailing Address
First Line : 520 CHADBOURNE RD
Second Line :
City : FAIRFIELD
State : CA
Zip : 94534-9656
Country : US
Telephone Number : 707-366-3600
Fax Number :
Provider Business Practice Location Address
First Line : 520 CHADBOURNE RD
Second Line :
City : FAIRFIELD
State : CA
Zip : 94534-9656
Country : US
Telephone Number : 707-366-3600
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/06/2008
Last Update Date : 06/22/2022

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Directions to “ BRIDGET SMITH M.S.” Practice Location

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