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General NPI Number Information
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NPI Number | 1073646899
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Entity Type | Organization
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Legal Business Name | THE BRIDGE, J. STANLEY BUNCE, PH.D., & ASSOCIATES
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Dates
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Enumeration Date | 03/13/2007
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Last Update Date | 12/11/2007
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Provider Practice Location Address
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Address Line | 118 PARK AVENUE
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City | MERCED
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State | CA
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Zip | 95348-3421
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Country | US
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Telephone | 209-384-0414
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Fax | 209-384-1562
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Provider Business Mailing Address
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Address Line | 118 PARK AVE
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City | MERCED
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State | CA
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Zip | 95348-3421
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Country | US
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Telephone | 209-384-0414
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Fax | 209-384-1562
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Authorized Official
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Title or Position | OWNER
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Name | DR. JON STANLEY BUNCE
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Credential | PH.D.
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Telephone | 209-384-0414
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number |
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License Number State |
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