MEDICARE: NEW BRIDGE FOUNDATION

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	324500000X	Substance Abuse Rehabilitation Facility	010013AN	CA

General Provider Information

NPI Number	:	1750392353
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	NEW BRIDGE FOUNDATION

Provider Business Mailing Address
First Line	:	2323 HEARST AVE
Second Line	:
City	:	BERKELEY
State	:	CA
Zip	:	94709-1319
Country	:	US
Telephone Number	:	510-526-6200
Fax Number	:	510-665-3176

Provider Business Practice Location Address
First Line	:	1816 SCENIC AVE
Second Line	:
City	:	BERKELEY
State	:	CA
Zip	:	94709-1324
Country	:	US
Telephone Number	:	510-548-7270
Fax Number	:	510-548-1060

Authorized Official
Title or Position	:	DIRECTOR OF ADMINISTRATION
Name	:	MRS. NATHALIE MARIE GIREAUD-FERKO
Credential	:	MA
Telephone Number	:	510-526-6200

Provider Enumeration Date	:	08/10/2006
Last Update Date	:	07/23/2013

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Directions to “NEW BRIDGE FOUNDATION ” Practice Location

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