Provider Demographics
NPI:1407067788
Name:BRIDGES, STEVEN E SR (MA)
Entity Type:Individual
Prefix:
First Name:STEVEN
Middle Name:E
Last Name:BRIDGES
Suffix:SR
Gender:M
Credentials:MA
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 2922
Mailing Address - Street 2:
Mailing Address - City:ANTIOCH
Mailing Address - State:CA
Mailing Address - Zip Code:94531-2922
Mailing Address - Country:US
Mailing Address - Phone:925-997-2464
Mailing Address - Fax:925-757-6459
Practice Address - Street 1:101 H ST STE 8
Practice Address - Street 2:
Practice Address - City:ANTIOCH
Practice Address - State:CA
Practice Address - Zip Code:94509-1279
Practice Address - Country:US
Practice Address - Phone:925-997-2464
Practice Address - Fax:925-756-6097
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-25
Last Update Date:2018-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA50811106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist