| Bridgman Psychological Services, P.c. | |
|
22792 Centre Dr Ste 290 Lake Forest CA 92630-6304 | |
| (949) 707-6633 | |
| (949) 770-5433 |
| Full Name | Bridgman Psychological Services, P.c. |
|---|---|
| Speciality | Psychologist |
| Location | 22792 Centre Dr Ste 290, Lake Forest, California |
| Authorized Official Name and Position | Laird Bridgman (PRESIDENT) |
| Authorized Official Contact | 9497076633 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Bridgman Psychological Services, P.c. 22792 Centre Dr Ste 290 Lake Forest CA 92630-6304 Ph: (949) 707-6633 | Bridgman Psychological Services, P.c. 22792 Centre Dr Ste 290 Lake Forest CA 92630-6304 Ph: (949) 707-6633 |
| NPI Number | 1386811776 |
|---|---|
| Provider Enumeration Date | 05/14/2008 |
| Last Update Date | 05/14/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1386811776 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103T00000X | Psychologist | PSY14510 (California) | Primary |
| 106H00000X | Marriage & Family Therapist | MFC28928 (California) | Secondary |
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