| Angel Bridge, Inc | |
|
1414 E Thousand Oaks Blvd #103 Thousand Oaks CA 91362-4401 | |
| (805) 371-1679 | |
| Not Available |
| Full Name | Angel Bridge, Inc |
|---|---|
| Speciality | Marriage & Family Therapist |
| Location | 1414 E Thousand Oaks Blvd, Thousand Oaks, California |
| Authorized Official Name and Position | Mary Jayne Carlson-collins (OWNER) |
| Authorized Official Contact | 8053711679 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Angel Bridge, Inc 1414 E Thousand Oaks Blvd #103 Thousand Oaks CA 91362-4401 Ph: (805) 371-1679 | Angel Bridge, Inc 1414 E Thousand Oaks Blvd #103 Thousand Oaks CA 91362-4401 Ph: (805) 371-1679 |
| NPI Number | 1578635629 |
|---|---|
| Provider Enumeration Date | 11/14/2006 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1578635629 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 106H00000X | Marriage & Family Therapist | MA14528 (California) | Primary |
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