Provider Demographics
NPI:1972127926
Name:HEDGES, BROGHAN A (MSW)
Entity type:Individual
Prefix:
First Name:BROGHAN
Middle Name:A
Last Name:HEDGES
Suffix:
Gender:
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 140881
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37214-0881
Mailing Address - Country:US
Mailing Address - Phone:831-227-9072
Mailing Address - Fax:
Practice Address - Street 1:401 PIERCE RD
Practice Address - Street 2:
Practice Address - City:MENLO PARK
Practice Address - State:CA
Practice Address - Zip Code:94025-1240
Practice Address - Country:US
Practice Address - Phone:831-227-9072
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-06-05
Last Update Date:2025-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA1283331041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical