Provider Demographics
NPI:1548402043
Name:BRIDGES BEHAVIORAL LANGUAGE SYSTEMS, INC.
Entity Type:Organization
Organization Name:BRIDGES BEHAVIORAL LANGUAGE SYSTEMS, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SENIOR CLINICAL PROGRAM DIRECTOR
Authorized Official - Prefix:PROF
Authorized Official - First Name:AUDREY
Authorized Official - Middle Name:JOAN
Authorized Official - Last Name:GIFFORD
Authorized Official - Suffix:
Authorized Official - Credentials:BCBA
Authorized Official - Phone:916-725-1270
Mailing Address - Street 1:6060 SUNRISE VISTA DR
Mailing Address - Street 2:SUITE 2340
Mailing Address - City:CITRUS HEIGHTS
Mailing Address - State:CA
Mailing Address - Zip Code:95610-7053
Mailing Address - Country:US
Mailing Address - Phone:916-725-1270
Mailing Address - Fax:916-725-1205
Practice Address - Street 1:6060 SUNRISE VISTA DR
Practice Address - Street 2:SUITE 2340
Practice Address - City:CITRUS HEIGHTS
Practice Address - State:CA
Practice Address - Zip Code:95610-7053
Practice Address - Country:US
Practice Address - Phone:916-725-1270
Practice Address - Fax:916-725-1205
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-03-30
Last Update Date:2009-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Single Specialty