Active NPI
Courtney Noelle Bridge
- Speech-Language Pathologist
- Alameda, CA
National Provider Identifier
1982353678
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- 28849
- Practice address
- 1219 Pease CT
Alameda, CA 94501-4617 - Phone
- (772) 353-2150
- NPI assigned
- Mar 21, 2022
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Speech-Language Pathologist | 235Z00000X | 030342-01 | NY | |
| Speech-Language Pathologist | 235Z00000X | 28849 | CA | Primary |
Addresses
Primary practice location
1219 Pease CT
Alameda, CA 94501-4617
Mailing address
1219 Pease CT
Alameda, CA 94501-4617
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 28849 | CA | MD | Clinical Social Worker |
| 030342-01 | NY | MD | Speech-Language Pathologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1647820800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1647820800000",
"number": "1982353678",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1219 PEASE CT",
"city": "ALAMEDA",
"state": "CA",
"postal_code": "945014617"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1219 PEASE CT",
"city": "ALAMEDA",
"state": "CA",
"postal_code": "945014617",
"telephone_number": "772-353-2150"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BRIDGE",
"first_name": "COURTNEY NOELLE",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2022-03-21",
"last_updated": "2022-03-21",
"certification_date": "2022-03-21",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "NY",
"license": "030342-01",
"primary": false
},
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "CA",
"license": "28849",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Alameda, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 21, 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.