Provider Demographics
NPI:1548562754
Name:ANDERSON, BRIDGET (ND)
Entity Type:Individual
Prefix:DR
First Name:BRIDGET
Middle Name:
Last Name:ANDERSON
Suffix:
Gender:F
Credentials:ND
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:511 E 1ST ST STE G
Mailing Address - Street 2:
Mailing Address - City:TUSTIN
Mailing Address - State:CA
Mailing Address - Zip Code:92780-3350
Mailing Address - Country:US
Mailing Address - Phone:714-660-8933
Mailing Address - Fax:949-476-3279
Practice Address - Street 1:511 E 1ST ST STE G
Practice Address - Street 2:
Practice Address - City:TUSTIN
Practice Address - State:CA
Practice Address - Zip Code:92780-3350
Practice Address - Country:US
Practice Address - Phone:714-660-8933
Practice Address - Fax:949-476-3279
Is Sole Proprietor?:No
Enumeration Date:2010-11-19
Last Update Date:2022-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAND-436175F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175F00000XOther Service ProvidersNaturopath