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General NPI Number Information
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NPI Number | 1922447481
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Entity Type | Individual
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Provider Name | CLARICE ILEAN BRIDGES (RN-241415), MSN, (P
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Gender | Female
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Dates
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Enumeration Date | 06/18/2013
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Last Update Date | 06/18/2013
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Provider Practice Location Address
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Address Line | 4600 BROADWAY - SUITE 1300
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City | SACRAMENTO
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State | CA
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Zip | 95820
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Country | US
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Telephone | 916-874-9823
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Fax | 916-874-9442
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Provider Business Mailing Address
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Address Line | 7001-A EAST PARKWAY SUITE 250
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City | SACRAMENTO
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State | CA
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Zip | 95823
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Country | US
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Telephone | 916-876-8852
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Fax | 916-391-0762
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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 | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | 241415(RN)
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 163WC0400X
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Taxonomy Name | Case Management Registered Nurse
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License Number | 83883(PHN)
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License Number State | CA
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Taxonomy #3
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Taxonomy Code | 163WC1500X
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Taxonomy Name | Community Health Registered Nurse
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License Number | 83883(PHN)
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License Number State | CA
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