Active NPI
Bridgette Sullivan, PHARMD
- Pharmacist
- Seaside, CA
National Provider Identifier
1053689166
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 64045
- Practice address
- 1055 Fremont Blvd
Seaside, CA 93955-5712 - Phone
- (831) 393-9231
- NPI assigned
- Dec 3, 2011
- Last updated
- Dec 3, 2011
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 64045 | CA | Primary |
Addresses
Primary practice location
1055 Fremont Blvd
Seaside, CA 93955-5712
Mailing address
901 Hawthorne St Apt C
Monterey, CA 93940-1182
Phone (847) 721-4523
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Pharmacy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 64045 | CA | MD | Clinical Social Worker |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Walgreen Co | Past | Accepting new patients | |
| Walgreen Co | Past | Accepting new patients |
Organizations & group practices 2
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1322870400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1322870400000",
"number": "1053689166",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "901 HAWTHORNE ST APT C",
"city": "MONTEREY",
"state": "CA",
"postal_code": "939401182",
"telephone_number": "847-721-4523"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1055 FREMONT BLVD",
"city": "SEASIDE",
"state": "CA",
"postal_code": "939555712",
"telephone_number": "831-393-9231"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SULLIVAN",
"first_name": "BRIDGETTE",
"name_prefix": "Dr.",
"credential": "PHARMD",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2011-12-03",
"last_updated": "2011-12-03",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "CA",
"license": "64045",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Seaside, CA
- Jayne Erin Smith, PHD, LPCC
- Rebecca Lee Smith, ACSW
- Shannon Sullivan Smithson, PA-C
- Renee Sosa, M.D.
- Kimberly Anne Spirito
- Christina Sullivan, MSW
- Suman Ramakumar DDS Inc (ACCU Dental & Orthodontics)
- Sumeet Singh, DDS, a Dental Corporation (Central Coast Dental Care)
- Charlisha Sumler, RADT R1329651118
- Sun Street Centers
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 3, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.