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Mr. Jonathan Blakely Brugge, BASWCADCA
Student in an Organized Health Care Education/Training Program in South Pasadena, California
NPI 1689920985

Jonathan Blakely Brugge is a Student in an Organized Health Care Education/Training Program based in South Pasadena, CA. Jonathan Blakely Brugge practices in South Pasadena, CA and has the professional credentials of BASWCADCA. The NPI Number for Jonathan Blakely Brugge is 1689920985 and holds a License No. (California).

The current practice location address for Jonathan Blakely Brugge is 616 Prospect Ave Apt 2, South Pasadena, CA and can be reached out via phone at 323-770-2345.

Location: 616 Prospect Ave Apt 2, South Pasadena, CA, 91030-2433
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1689920985
Provider Name
Jonathan Blakely Brugge
Credential
BASWCADCA
Provider Entity Type
Individual
Gender
Male
Address
616 Prospect Ave Apt 2, South Pasadena, CA, 91030-2433
Phone Number
323-770-2345
Fax Number
Provider Enumeration Date
07/24/2012
Last Update Date
03/09/2024
institution
Provider Business Practice Location Address Details
Address
616 Prospect Ave Apt 2
City
South Pasadena
State
California
Zip
91030-2433
Phone Number
323-770-2345
Fax Number
person
Provider Business Mailing Address Details
Address
616 Prospect Ave Apt 2
City
South Pasadena
State
California
Zip
91030-2433
Phone Number
323-770-2345
Fax Number
person
Provider's Taxonomy Details 1
Type
Student, Health Care
Classification
Student in an Organized Health Care Education/Training Program
Speciality
-
Taxonomy
390200000X
License No.
()
Definition
An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.
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