Provider Demographics
NPI:1538034764
Name:VALLEY BRIDGE RESOURCE CENTER, INC.
Entity type:Organization
Organization Name:VALLEY BRIDGE RESOURCE CENTER, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:KHRIST
Authorized Official - Middle Name:
Authorized Official - Last Name:KAKOSIMIDI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:818-807-0530
Mailing Address - Street 1:12541 JOLETTE AVE
Mailing Address - Street 2:
Mailing Address - City:GRANADA HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:91344-1661
Mailing Address - Country:US
Mailing Address - Phone:818-807-0530
Mailing Address - Fax:
Practice Address - Street 1:1561 S 4TH ST STE B
Practice Address - Street 2:
Practice Address - City:EL CENTRO
Practice Address - State:CA
Practice Address - Zip Code:92243-4560
Practice Address - Country:US
Practice Address - Phone:818-807-0530
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-10-07
Last Update Date:2025-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Multi-Specialty
No103TB0200XBehavioral Health & Social Service ProvidersPsychologistCognitive & BehavioralGroup - Multi-Specialty
No251C00000XAgenciesDay Training, Developmentally Disabled Services
No251S00000XAgenciesCommunity/Behavioral Health
No252Y00000XAgenciesEarly Intervention Provider Agency
No342000000XTransportation ServicesTransportation Network Company