Av Bridges Mental Health Corp

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

Legal business name

AV BRIDGES MENTAL HEALTH CORP

Practice address

1331 W. Ave J
Unit 101a
Lancaster, CA 93534

Phone

(661) 310-3110

Fax

(661) 310-3112

NPI assigned

Oct 24, 2023

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Vincent Estacio

Title

RN/Ceo

Phone

(661) 310-3110

Specialties & licenses 2

Addresses

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1698105600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1715558400000",
    "number": "1114799178",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1331 W. AVE J",
            "address_2": "UNIT 101A",
            "city": "LANCASTER",
            "state": "CA",
            "postal_code": "93534",
            "telephone_number": "661-310-3110",
            "fax_number": "661-310-3112"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1331 W. AVE J",
            "address_2": "UNIT 101A",
            "city": "LANCASTER",
            "state": "CA",
            "postal_code": "93534",
            "telephone_number": "661-310-3110",
            "fax_number": "661-310-3112"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AV BRIDGES MENTAL HEALTH CORP",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-10-24",
        "last_updated": "2024-05-13",
        "certification_date": "2024-05-13",
        "status": "A",
        "authorized_official_last_name": "ESTACIO",
        "authorized_official_first_name": "VINCENT",
        "authorized_official_title_or_position": "RN/CEO",
        "authorized_official_telephone_number": "661-310-3110"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Psychiatry Physician in Lancaster, CA
• Providers in Lancaster, CA by specialty
• Psychiatry Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 13, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.