Provider Demographics
NPI:1376785063
Name:BRIDGES, ALGRIE MONIQUE (MA, AMFT)
Entity Type:Individual
Prefix:
First Name:ALGRIE
Middle Name:MONIQUE
Last Name:BRIDGES
Suffix:
Gender:F
Credentials:MA, AMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 8181
Mailing Address - Street 2:
Mailing Address - City:MORENO VALLEY
Mailing Address - State:CA
Mailing Address - Zip Code:92552-8181
Mailing Address - Country:US
Mailing Address - Phone:916-995-3289
Mailing Address - Fax:
Practice Address - Street 1:3425 MARTIN LUTHER KING JR BLVD
Practice Address - Street 2:
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95817-3648
Practice Address - Country:US
Practice Address - Phone:916-541-5737
Practice Address - Fax:916-550-1422
Is Sole Proprietor?:Yes
Enumeration Date:2009-03-27
Last Update Date:2022-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA261QM0801X
101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)