MEDICARE: MRS. BRIDGET MARY EARL MFT

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	106H00000X	Marriage & Family Therapist	MFC 41907	CA

General Provider Information

NPI Number	:	1053442285
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. BRIDGET MARY EARL MFT

Provider Business Mailing Address
First Line	:	535 S SECOND AVE
Second Line	:
City	:	COVINA
State	:	CA
Zip	:	91723
Country	:	US
Telephone Number	:	626-974-0770
Fax Number	:	626-974-0774

Provider Business Practice Location Address
First Line	:	605 N PARK AVE
Second Line	:
City	:	POMONA
State	:	CA
Zip	:	91768-3622
Country	:	US
Telephone Number	:	909-964-8204
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/08/2007
Last Update Date	:	12/03/2025

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