Healthcare Provider Details

I. General information

NPI: 1265389167
Provider Name (Legal Business Name): BRIDGETTE ANDERSON MARRIAGE AND FAMILY THERAPY, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/11/2026
Last Update Date: 03/11/2026
Certification Date: 03/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

921 THE ALAMEDA STE 105
BERKELEY CA
94707-2311
US

IV. Provider business mailing address

340 45TH ST
OAKLAND CA
94609-2226
US

V. Phone/Fax

Practice location:
  • Phone: 415-952-6779
  • Fax:
Mailing address:
  • Phone: 415-952-6779
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number
License Number State

VIII. Authorized Official

Name: MS. BRIDGETTE ANDERSON
Title or Position: PRESIDENT
Credential: LMFT
Phone: 415-952-6779