Provider Demographics
NPI:1609891357
Name:FAMILY BRIDGES INC
Entity Type:Organization
Organization Name:FAMILY BRIDGES INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF EXECUTIVE OFFICER
Authorized Official - Prefix:MS
Authorized Official - First Name:CORINNE
Authorized Official - Middle Name:SUSAN
Authorized Official - Last Name:JAN
Authorized Official - Suffix:
Authorized Official - Credentials:RD
Authorized Official - Phone:510-839-2270
Mailing Address - Street 1:168 11TH ST
Mailing Address - Street 2:
Mailing Address - City:OAKLAND
Mailing Address - State:CA
Mailing Address - Zip Code:94607
Mailing Address - Country:US
Mailing Address - Phone:510-839-2022
Mailing Address - Fax:510-839-2435
Practice Address - Street 1:168 11TH ST
Practice Address - Street 2:
Practice Address - City:OAKLAND
Practice Address - State:CA
Practice Address - Zip Code:94607
Practice Address - Country:US
Practice Address - Phone:510-419-0888
Practice Address - Fax:510-419-0880
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-13
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Not Answered133NN1002XDietary & Nutritional Service ProvidersNutritionistNutrition, EducationGroup - Multi-Specialty
Not Answered261QM1300XAmbulatory Health Care FacilitiesClinic/CenterMulti-Specialty