Provider Demographics
NPI:1083180780
Name:BURRIDGE, ADAM JOESPH
Entity Type:Individual
Prefix:
First Name:ADAM
Middle Name:JOESPH
Last Name:BURRIDGE
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1906 RED ROSE WAY APT C
Mailing Address - Street 2:
Mailing Address - City:SANTA BARBARA
Mailing Address - State:CA
Mailing Address - Zip Code:93109-1553
Mailing Address - Country:US
Mailing Address - Phone:805-455-2743
Mailing Address - Fax:
Practice Address - Street 1:1906 RED ROSE WAY APT C
Practice Address - Street 2:
Practice Address - City:SANTA BARBARA
Practice Address - State:CA
Practice Address - Zip Code:93109-1553
Practice Address - Country:US
Practice Address - Phone:805-455-2743
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-10-19
Last Update Date:2018-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)