Dustin Brett Bridges, PHD

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

31370 Issued in CA

Practice address

1660 E Roseville Pkwy Ste 100
Roseville, CA 95661-3988

Phone

(916) 342-5168

NPI assigned

Jan 6, 2017

Sex

Male

Sole proprietor

Yes

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Kenneth L. Larson, PH.D., Inc.

  • Clinical Psychologist
  • Roseville, CA
  • NPI 1609396183
  NPD (past)

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

{
    "created_epoch": "1483660800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1644537600000",
    "number": "1407392012",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1891 E ROSEVILLE PKWY STE 100",
            "city": "ROSEVILLE",
            "state": "CA",
            "postal_code": "956617974",
            "telephone_number": "916-342-5168"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1660 E ROSEVILLE PKWY STE 100",
            "city": "ROSEVILLE",
            "state": "CA",
            "postal_code": "956613988",
            "telephone_number": "916-342-5168"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRIDGES",
        "first_name": "DUSTIN",
        "middle_name": "BRETT",
        "name_prefix": "Dr.",
        "credential": "PHD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2017-01-06",
        "last_updated": "2022-02-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CA",
            "license": "31370",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/ncalceq",
            "affiliation": "Y",
            "endpointDescription": "Carequality",
            "affiliationName": "The Permanente Medical Group",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "C-CDA",
            "address_1": "8247 E. Stockton Blvd",
            "city": "Sacramento",
            "state": "CA",
            "country_code": "US",
            "postal_code": "95828",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Ligia Bremerman, LCSW
• Brett Martin, DDS, Inc.
• Carl Raymond Brew, RN
• Gregory Michael Bricca, MD
• Ryan Brice
• Bridgeway Christian Church
• Vanessa Brien, PSY.D.
• Alta Moraine Briggs, AMFT
• Bright Beginnings Therapy, Inc.
• Bright Start Therapies, Inc.

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 11, 2022; 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.