Provider Demographics
NPI:1417462011
Name:BRIDGE PSYCHOLOGICAL SERVICES, INC.
Entity Type:Organization
Organization Name:BRIDGE PSYCHOLOGICAL SERVICES, INC.
Other - Org Name:DANA MEEKS PSYD
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER & CLINICAL DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:DANA
Authorized Official - Middle Name:
Authorized Official - Last Name:MEEKS
Authorized Official - Suffix:
Authorized Official - Credentials:PSYD
Authorized Official - Phone:510-338-3325
Mailing Address - Street 1:410 12TH ST STE 325
Mailing Address - Street 2:
Mailing Address - City:OAKLAND
Mailing Address - State:CA
Mailing Address - Zip Code:94607-4489
Mailing Address - Country:US
Mailing Address - Phone:510-338-3325
Mailing Address - Fax:510-495-6955
Practice Address - Street 1:410 12TH ST STE 325
Practice Address - Street 2:
Practice Address - City:OAKLAND
Practice Address - State:CA
Practice Address - Zip Code:94607-4489
Practice Address - Country:US
Practice Address - Phone:510-338-3325
Practice Address - Fax:510-495-6955
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-12-06
Last Update Date:2021-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY28846103TC1900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounselingGroup - Single Specialty