Healthcare Provider Details

I. General information

NPI: 1023559846
Provider Name (Legal Business Name): BRIGHT HEART HEALTH, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/13/2017
Last Update Date: 03/13/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4411 DUPONT CT SUITE 120
VENTURA CA
93003-7758
US

IV. Provider business mailing address

2603 CAMINO RAMON SUITE 200
SAN RAMON CA
94583-9126
US

V. Phone/Fax

Practice location:
  • Phone: 844-884-4474
  • Fax: 415-458-2691
Mailing address:
  • Phone: 844-884-4474
  • Fax: 415-458-2691

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174400000X
TaxonomySpecialist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number
License Number State

VIII. Authorized Official

Name: JONATHAN CIAMPI
Title or Position: CEO
Credential:
Phone: 844-884-4474