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NPI Code Detail

MEDICARE: BRIDGES BEHAVIORAL LANGUAGE SYSTEMS, INC.

MEDICARE: BRIDGES BEHAVIORAL LANGUAGE SYSTEMS, INC.
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
1103K00000XBehavior Analyst

General Provider Information

NPI Number : 1548402043
Entity Type Code : Organization
Provider Name (Legal Business Name) : BRIDGES BEHAVIORAL LANGUAGE SYSTEMS, INC.
Provider Business Mailing Address
First Line : 6060 SUNRISE VISTA DR
Second Line : SUITE 2340
City : CITRUS HEIGHTS
State : CA
Zip : 95610-7053
Country : US
Telephone Number : 916-725-1270
Fax Number : 916-725-1205
Provider Business Practice Location Address
First Line : 6060 SUNRISE VISTA DR
Second Line : SUITE 2340
City : CITRUS HEIGHTS
State : CA
Zip : 95610-7053
Country : US
Telephone Number : 916-725-1270
Fax Number : 916-725-1205
Authorized Official
Title or Position : SENIOR CLINICAL PROGRAM DIRECTOR
Name : PROF. AUDREY JOAN GIFFORD
Credential : BCBA
Telephone Number : 916-725-1270
Provider Enumeration Date : 03/30/2009
Last Update Date : 03/30/2009

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Directions to “BRIDGES BEHAVIORAL LANGUAGE SYSTEMS, INC. ” Practice Location

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