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NPI Code Detail

MEDICARE: BRIDGETTE WASHINGTON

MEDICARE: BRIDGETTE WASHINGTON
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
1101YA0400XAddiction (Substance Use Disorder) CounselorRI-W1304291451CA

General Provider Information

NPI Number : 1619107737
Entity Type Code : Individual
Provider Name (Legal Business Name) : BRIDGETTE WASHINGTON
Provider Business Mailing Address
First Line : 520 SAN PABLO DAM RD
Second Line :
City : ORINDA
State : CA
Zip : 94563-1604
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 1249 SCOTT ST
Second Line :
City : SAN FRANCISCO
State : CA
Zip : 94115-4008
Country : US
Telephone Number : 415-922-9104
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/23/2009
Last Update Date : 10/18/2016

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Directions to “ BRIDGETTE WASHINGTON ” Practice Location

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