Marie Bridgeford

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

PSY29716 Issued in CA

Practice address

2120 Alpine Blvd
Alpine, CA 91901-2113

Phone

(619) 722-7319

NPI assigned

Oct 8, 2014

Last updated

Oct 15, 2021By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in CA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Clinical Psychologist

Education

Other, 2015

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Providence Medical FoundationGroup PAC ID 8921993205, 1,461 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Providence Medical Foundation

  • Family Medicine Physician
  • Brea, CA
  • NPI 1871607762
  Medicare reassignment Care Compare group
• Oscar Oo, PSY.D.

  • Clinical Psychologist
  • Newport Beach, CA
  • NPI 1427128156
  Medicare reassignment
• Providence Medical Foundation

  • General Practice Physician
  • Diamond Bar, CA
  • NPI 1285890624
  NPD
• Providence Medical Foundation

  • Family Medicine Physician
  • Anaheim, CA
  • NPI 1639715709
  NPD
• Providence Medical Foundation

  • Internal Medicine Physician
  • Santa Rosa, CA
  • NPI 1740584473
  NPD

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

{
    "created_epoch": "1412726400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1634256000000",
    "number": "1144623869",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2120 ALPINE BLVD",
            "city": "ALPINE",
            "state": "CA",
            "postal_code": "919012113",
            "telephone_number": "619-722-7319"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2120 ALPINE BLVD",
            "city": "ALPINE",
            "state": "CA",
            "postal_code": "919012113",
            "telephone_number": "619-722-7319"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRIDGEFORD",
        "first_name": "MARIE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-10-08",
        "last_updated": "2021-10-15",
        "certification_date": "2021-10-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CA",
            "license": "PSY29716",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mbridgeford1757060@oc.providencedirect.org",
            "affiliation": "N",
            "address_1": "2280 Harrison Ave Ste K",
            "city": "Eureka",
            "state": "CA",
            "country_code": "US",
            "postal_code": "955013200",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Bold Plate Nutrition, LLC
• Jonar R Bonifacio, DDS
• Jennifer Boules-Syta
• Cybill Bowens-Vargas
• Linda A Branch, RDA
• Abigail Kate Brown
• Paul Brown, CMT
• Atley Buechler
• Jesse Bullock
• Edwin Humberto Cabrera, M.D.

• Clinical Psychologist in Alpine, CA
• Providers in Alpine, CA by specialty
• Clinical Psychologist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 15, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.