Healthcare Provider Details

I. General information

NPI: 1548133341
Provider Name (Legal Business Name): BRIDGEDPSYCH EDUCATIONAL PSYCHOLOGY PROFESSIONAL CORPORATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/26/2025
Last Update Date: 05/29/2026
Certification Date: 05/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

920 20TH ST
SACRAMENTO CA
95811-3133
US

IV. Provider business mailing address

920 20TH ST
SACRAMENTO CA
95811-3133
US

V. Phone/Fax

Practice location:
  • Phone: 916-500-4344
  • Fax:
Mailing address:
  • Phone: 916-500-4344
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code103T00000X
TaxonomyPsychologist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code103TB0200X
TaxonomyCognitive & Behavioral Psychologist
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code103TM1800X
TaxonomyIntellectual & Developmental Disabilities Psychologist
License Number
License Number State
# 4
Primary TaxonomyY
Taxonomy Code103TS0200X
TaxonomySchool Psychologist
License Number
License Number State

VIII. Authorized Official

Name: ASHLEY BURCIAGA
Title or Position: CEO/FOUNDER
Credential: EDD, LEP
Phone: 916-500-4344