Healthcare Provider Details

I. General information

NPI: 1609436534
Provider Name (Legal Business Name): BRIDGES FAMILY THERAPY INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/13/2019
Last Update Date: 09/03/2026
Certification Date: 09/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

918 15TH ST
MODESTO CA
95354-1115
US

IV. Provider business mailing address

226 W OJAI AVE STE 101-180
OJAI CA
93023-3277
US

V. Phone/Fax

Practice location:
  • Phone: 805-707-4625
  • Fax: 805-232-3224
Mailing address:
  • Phone: 805-798-3150
  • Fax: 805-232-3224

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number
License Number State

VIII. Authorized Official

Name: PATRICIA GATES ANDERSON
Title or Position: CEO
Credential: LMFT
Phone: 805-707-4625