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General NPI Number Information
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NPI Number | 1407742943
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Entity Type | Individual
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Provider Name | BRIDGET MUDD MPSS
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Gender | Female
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Dates
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Enumeration Date | 06/12/2025
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Last Update Date | 06/12/2025
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Provider Practice Location Address
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Address Line | 200 EDMONDS RD
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City | REDWOOD CITY
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State | CA
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Zip | 94062-3813
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Country | US
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Telephone | 650-930-7494
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Fax |
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Provider Business Mailing Address
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Address Line | 5254 HEAVENLY RIDGE LN
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City | EL SOBRANTE
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State | CA
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Zip | 94803-2629
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Country | US
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Telephone | 504-717-6735
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 175T00000X
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Taxonomy Name | Peer Specialist
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License Number | MPSS-SJRLQN
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License Number State | CA
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