Healthcare Provider Details

I. General information

NPI: 1548567167
Provider Name (Legal Business Name): GIANNA COLAVIN-BRIDGES LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/16/2011
Last Update Date: 01/13/2026
Certification Date: 01/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2403 PROFESSIONAL DR STE 101
SANTA ROSA CA
95403-3007
US

IV. Provider business mailing address

2403 PROFESSIONAL DR STE 101
SANTA ROSA CA
95403-3007
US

V. Phone/Fax

Practice location:
  • Phone: 707-253-4279
  • Fax:
Mailing address:
  • Phone: 707-544-3295
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number83131
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: