STEPHEN PETER BRADLEY (NPI# 1699746446) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1699746446 |
| Entity Type | Individual |
| Full Name | STEPHEN PETER BRADLEY |
| Credential | MD |
| Practice Address |
5375 Lakeshore Blvd Lakeport CA 95453-6123 |
| Practice Telephone | 7072635679 |
| Practice Fax Number | 7072637781 |
| Mailing Telephone | 7072635679 |
| Mailing Fax Number | 7072637781 |
| Enumeration Date | 2006-01-30 |
| Last Update Date | 2019-11-05 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207QA0401X |
Family Medicine Specialization: Addiction Medicine |
C41489 | CA | Allopathic & Osteopathic Physicians |
| N | 208600000X | Surgery | C414890 | CA | Allopathic & Osteopathic Physicians |
| N | 208D00000X | General Practice | C414890 | CA | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CA | 00C414890 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1457455024 | Stephen E Bradley | Dentist | 821 24th Ave Nw, Norman, OK 73069-6313 | 2006-09-12 |
| 1134222011 | Stephen Bradley | Physician Assistant | 740 Memorial St, Prosser, WA 99350-1525 | 2006-09-06 |
| 1588036982 | Stephen Bradley | Pharmacist | 1896 Route 6, Carmel, NY 10512-2355 | 2015-10-24 |
| 1861700734 | Stephen Bradley | Counselor | 419 E 7th St Ste 207, The Dalles, OR 97058-2676 | 2010-09-14 |
| 1558505537 | Stephen Ralph Bradley | Dentist | 307 Maple Ave W, Suite G, Vienna, VA 22180-4307 | 2009-04-22 |
| 1972671261 | Stephen James Bradley | Counselor | 8 Trumbull Rd, Suite 202, Northampton, MA 01060-3079 | 2006-12-02 |
| 1295825651 | Stephen P Bradley | General Practice | 86-260 Farrington Hwy, Waianae, HI 96792-3128 | 2006-10-13 |
| 1508950296 | Stephen K Bradley | Anesthesiology | 9660 South 1300 East, Alta View Hospital, Sandy, UT 84094 | 2006-10-03 |
| 1699874644 | Stephen P. Bradley | Internal Medicine | 10666 N Torrey Pines Rd, La Jolla, CA 92037-1027 | 2006-09-22 |
| 1164455028 | Stephen Jerome Bradley | Surgery | 4160 John R St, Ste 615, Detroit, MI 48201-2020 | 2006-07-07 |
| Street Address |
5375 LAKESHORE BLVD |
| City | LAKEPORT |
| State | CA |
| Zip Code | 95453-6123 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1427526847 | Easter Seals Bay Area | Early Intervention Provider Agency | 1950 Parallel Drive, Lakeport, CA 95453 | 2018-11-03 |
| 1285000810 | Lake County Tribal Health Consortium, Inc. | Clinic/Center | 14678 Lakeshore Boulevard, Clearlake, CA 95453 | 2015-08-18 |
| 1942558721 | Lorena A Watson | Nurse Practitioner | 5108 Hill Road East, Lakeport, CA 95453 | 2012-08-27 |
| 1992024657 | Jennifer Stolworthy Smith | Case Manager/Care Coordinator | 991 Parallel Dr. Ste. B, County of Lake, Mental Health, Lakeport, CA 95453 | 2010-05-20 |
| 1376720664 | June Arisa Masato | Marriage & Family Therapist | 1152 S. Main St, Lakeport, CA 95453 | 2008-01-29 |
| 1245417021 | Robert Ryan Taylor Sr. | Physical Therapist | 1285 S Main Street, Lakeport, CA 95453 | 2008-01-24 |
| 1760669618 | Joan Kammerer | Registered Nurse | 922 Bevins Court, Lakeport, CA 95453 | 2008-01-23 |
| 1881878353 | Mary Theresa Mcmillan | Marriage & Family Therapist | 75 Fourth Street, Lakeport, CA 95453 | 2007-12-19 |
| 1922288984 | Robert William Krause | Family Medicine | 755 Eleventh St, Lakeport, CA 95453 | 2007-11-07 |
| 1568683092 | Dan Sleeth | Marriage & Family Therapist | 991 Parallel Dr., Lakeport, CA 95453 | 2007-05-01 |
| Find all providers in zip 95453 | ||||
| Taxonomy Code | 207QA0401X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| Specialization | Addiction Medicine |
| A family medicine physician who specializes in the diagnosis and treatment of addictions. |
| Notes: Source: National Uniform Claim Committee, 2009 [1/1/2010: definition added, source added] Additional Resources: A Certification of Added Qualifications (CAQ) was, but is no longer issued by the American Osteopathic Board of Family Physicians. |
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| 1093363848 | Anthony Martin Ocana | Family Medicine | 13924 Marquesas Way Apt 1520, Marina Del Rey, CA 90292-6018 | 2019-08-26 |
| 1821640137 | L Snyder Incorporated | Family Medicine | 34052 La Plaza #101, Dana Point, CA 92629 | 2019-07-16 |
| 1720645328 | Creative Child and Family Services, Inc. | Family Medicine | 7049 Ohio River Dr, Eastvale, CA 91752 | 2019-05-20 |
| 1932666575 | Gold Country Health Initiative, LLC | Family Medicine | 820/830 State Highway 88, Jackson, CA 95642 | 2019-03-01 |
| 1629550660 | University of California Sfgh Medical Group | Family Medicine | 1001 Potrero Ave Rm 5h22, San Francisco, CA 94110-3518 | 2018-09-06 |
| 1952809592 | Sunrise Health & Wellness Center, LLC | Family Medicine | 10089 Folsom Blvd. Suites A & C, Rancho Cordova, CA 95670-1935 | 2018-01-29 |
| 1487166120 | Good Samaritan Shelter | Family Medicine | 412 East Tunnell Street, Santa Maria, CA 93454 | 2017-11-03 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.