Basic Information
| Provider Information | |||||||||
| NPI: | 1659762243 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | TRYGAR | ||||||||
| FirstName: | BRIDGET | ||||||||
| MiddleName: | |||||||||
| NamePrefix: | MS. | ||||||||
| NameSuffix: | |||||||||
| Credential: | R.N. | ||||||||
| OtherOrganizationName: | |||||||||
| OtherOrganizationType: | |||||||||
| OtherLastName: | FRANTZ | ||||||||
| OtherFirstName: | BRIDGET | ||||||||
| OtherMiddleName: | |||||||||
| OtherNamePrefix: | MR. | ||||||||
| OtherNameSuffix: | |||||||||
| OtherCredential: | LVN | ||||||||
| OtherLastNameType: | 1 | ||||||||
| Mailing Information | |||||||||
| Address1: | 931 WALNUT AVE | ||||||||
| Address2: | |||||||||
| City: | CARPINTERIA | ||||||||
| State: | CA | ||||||||
| PostalCode: | 930132028 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8055601058 | ||||||||
| FaxNumber: | 8055601051 | ||||||||
| Practice Location | |||||||||
| Address1: | 931 WALNUT AVE | ||||||||
| Address2: | |||||||||
| City: | CARPINTERIA | ||||||||
| State: | CA | ||||||||
| PostalCode: | 930132028 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8055601058 | ||||||||
| FaxNumber: | 8055601051 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 02/18/2015 | ||||||||
| LastUpdateDate: | 02/18/2015 | ||||||||
| NPIDeactivationReasonCode: | |||||||||
| NPIDeactivationDate: | |||||||||
| NPIReactivationDate: | |||||||||
| ProviderGenderCode: | F | ||||||||
| AuthorizedOfficialLastName: | |||||||||
| AuthorizedOfficialFirstName: | |||||||||
| AuthorizedOfficialMiddleName: | |||||||||
| AuthorizedOfficialTitleorPosition: | |||||||||
| AuthorizedOfficialTelephone: | |||||||||
| IsSoleProprietor: | N | ||||||||
| IsOrganizationSubpart: | |||||||||
| ParentOrganizationLBN: | |||||||||
| AuthorizedOfficialNamePrefix: | |||||||||
| AuthorizedOfficialNameSuffix: | |||||||||
| AuthorizedOfficialCredential: | |||||||||
| NPICertificationDate: | |||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 163WP2201X | 350864 | CA | Y | Nursing Service Providers | Registered Nurse | Ambulatory Care |
No ID Information.