Provider Demographics
NPI:1033324447
Name:FAMILY BRIDGES INC
Entity Type:Organization
Organization Name:FAMILY BRIDGES INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF EXECUTIVE OFFICER
Authorized Official - Prefix:MS
Authorized Official - First Name:CORINNE
Authorized Official - Middle Name:SUSAN
Authorized Official - Last Name:JAN
Authorized Official - Suffix:
Authorized Official - Credentials:RD
Authorized Official - Phone:510-839-2270
Mailing Address - Street 1:168 11TH STREET
Mailing Address - Street 2:
Mailing Address - City:OAKLAND
Mailing Address - State:CA
Mailing Address - Zip Code:94607
Mailing Address - Country:US
Mailing Address - Phone:510-839-2022
Mailing Address - Fax:510-839-2435
Practice Address - Street 1:275 14TH STREET
Practice Address - Street 2:
Practice Address - City:OAKLAND
Practice Address - State:CA
Practice Address - Zip Code:94612
Practice Address - Country:US
Practice Address - Phone:510-839-9673
Practice Address - Fax:510-839-9674
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-11
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA0600XAmbulatory Health Care FacilitiesClinic/CenterAdult Day Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAADU70200FOtherADHC