Healthcare Provider Details

I. General information

NPI: 1073484366
Provider Name (Legal Business Name): ASHLEY BRIDGMAN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/17/2025
Last Update Date: 09/17/2025
Certification Date: 09/17/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

39201 SUNDALE DR
FREMONT CA
94538-1916
US

IV. Provider business mailing address

732 WARRINGTON AVE
REDWOOD CITY CA
94063-3526
US

V. Phone/Fax

Practice location:
  • Phone: 510-657-5020
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WS0200X
TaxonomySchool Registered Nurse
License Number95384389
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: