Provider Demographics
NPI:1851816060
Name:BRIDGEVIEW PSYCHOLOGICAL SERVICES
Entity Type:Organization
Organization Name:BRIDGEVIEW PSYCHOLOGICAL SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PSYCHOLOGIST
Authorized Official - Prefix:DR
Authorized Official - First Name:LAUREN
Authorized Official - Middle Name:TRACEY
Authorized Official - Last Name:SEAY DASHJIAN
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:559-930-4695
Mailing Address - Street 1:PO BOX 1514
Mailing Address - Street 2:
Mailing Address - City:BENICIA
Mailing Address - State:CA
Mailing Address - Zip Code:94510-4514
Mailing Address - Country:US
Mailing Address - Phone:707-816-0963
Mailing Address - Fax:
Practice Address - Street 1:701 SOUTHAMPTON RD STE 209F
Practice Address - Street 2:
Practice Address - City:BENICIA
Practice Address - State:CA
Practice Address - Zip Code:94510-2055
Practice Address - Country:US
Practice Address - Phone:707-816-0963
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-08-08
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounselingGroup - Single Specialty