Provider Demographics
NPI:1922449131
Name:BERTRAND, BRIDGET HOPE (LMFT 83020)
Entity Type:Individual
Prefix:MS
First Name:BRIDGET
Middle Name:HOPE
Last Name:BERTRAND
Suffix:
Gender:F
Credentials:LMFT 83020
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:112 W 25TH AVE STE 1
Mailing Address - Street 2:210
Mailing Address - City:SAN MATEO
Mailing Address - State:CA
Mailing Address - Zip Code:94403-2264
Mailing Address - Country:US
Mailing Address - Phone:650-539-4325
Mailing Address - Fax:
Practice Address - Street 1:112 W 25TH AVE STE 1
Practice Address - Street 2:210
Practice Address - City:SAN MATEO
Practice Address - State:CA
Practice Address - Zip Code:94403-2264
Practice Address - Country:US
Practice Address - Phone:650-539-4325
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-07-16
Last Update Date:2014-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA83020106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist