Jonathan Blakely Brugge, BASW CADCA
Student in an Organized Health Care Education/Training Program in South Pasadena, CA. Individual provider (NPI-1).
Details
- NPI
- 1689920985
- Entity type
- Individual (NPI-1)
- Name
- Mr. Jonathan Blakely Brugge
- Credential
- BASW CADCA
- Sex
- Male
- Sole proprietor
- Yes
- Enumeration date
- Jul 24, 2012
- Last updated
- Sep 19, 2012
Medicare and OIG
- Medicare enrolled (PECOS)
- Not in the Medicare enrollment file
- Can order and refer
- Not on the CMS order and referring list
- OIG exclusion list
- This NPI is not listed
CMS and OIG files of November 2026. PECOS lookup · OIG exclusion check
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 390200000X | Student in an Organized Health Care Education/Training Program | – | – | Yes |
Practice location
616 Prospect Ave Apt 2South Pasadena, CA 91030-2433
Phone 323-770-2345
Mailing address
616 Prospect Ave Apt 2South Pasadena, CA 91030-2433
Phone 323-770-2345
Is something wrong?
This page shows exactly what the provider filed with NPPES. Only the provider (or their surrogate) can change it, by signing in to NPPES. Our page updates within a day of their change. See how to update NPI information.
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All 25 Student in an Organized Health Care Education/Training Program providers in South Pasadena · All 1,268 providers in South Pasadena
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