Healthcare Provider Details

I. General information

NPI: 1710173992
Provider Name (Legal Business Name): BRIDGETTE BARTEL
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/20/2007
Last Update Date: 02/03/2022
Certification Date: 02/03/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3641 STONY POINT RD
SANTA ROSA CA
95407-8080
US

IV. Provider business mailing address

906 PIERCE ST APT D
ALBANY CA
94706-1568
US

V. Phone/Fax

Practice location:
  • Phone: 707-585-3700
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: