Provider Demographics
NPI:1982426763
Name:BRIDGES, CELINA RENE
Entity type:Individual
Prefix:
First Name:CELINA
Middle Name:RENE
Last Name:BRIDGES
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4701 NAVAHO CT
Mailing Address - Street 2:
Mailing Address - City:DENAIR
Mailing Address - State:CA
Mailing Address - Zip Code:95316-9371
Mailing Address - Country:US
Mailing Address - Phone:209-501-3077
Mailing Address - Fax:
Practice Address - Street 1:4701 NAVAHO CT
Practice Address - Street 2:
Practice Address - City:DENAIR
Practice Address - State:CA
Practice Address - Zip Code:95316-9371
Practice Address - Country:US
Practice Address - Phone:209-501-3077
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-10-31
Last Update Date:2024-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator