Individual provider Active NPI

India Gladyes Bradley, LMFT

  • Marriage & Family Therapist
  • East Palo Alto, CA
National Provider Identifier
1003549536
Registry record updated Apr 10, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
LMFT154215 Issued in CA
Practice address
2415 University Ave Ste 301
East Palo Alto, CA 94303-1148
Phone
(650) 363-4030
NPI assigned
Jul 1, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 10, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family Therapist 106H00000X LMFT154215 CA Primary

Addresses

Primary practice location

2415 University Ave Ste 301
East Palo Alto, CA 94303-1148

Mailing address

2415 University Ave
East Palo Alto, CA 94303-1164

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250529001989 CA Practitioner - Marriage and Family Therapist 7416476742 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Marriage and Family Therapist
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
County of San MateoGroup PAC ID 9032023171, 316 clinicians

Practice addresses (Care Compare)

802 Brewster Ave
Redwood City, CA 94063-1510
Phone (650) 573-2222

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
LMFT154215CAMDMarriage & Family Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
County of San Mateo Current Accepting new patients
San Mateo County Marriage & Family Therapist CurrentSince Apr 13, 2025 Accepting new patients
San Mateo County Marriage & Family Therapist CurrentSince Apr 1, 2025 Accepting new patients
County of San Mateo CurrentSince Apr 1, 2025 Accepting new patients

Locations

375 89th St
Daly City, CA 94015
Phone (650) 301-8650

2415 University Ave
East Palo Alto, CA 94303
Phone (650) 363-4030

2415 University Ave
Ste 301
East Palo Alto, CA 94303
Phone (650) 363-4030

802 Brewster Ave
Redwood City, CA 94063
Phone (650) 363-4111

222 W 39th Ave
San Mateo, CA 94403
Phone (415) 573-2222

1950 Alameda de las Pulgas
San Mateo, CA 94403
Phone (650) 573-3571

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1656633600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1744243200000",
    "number": "1003549536",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2415 UNIVERSITY AVE",
            "city": "EAST PALO ALTO",
            "state": "CA",
            "postal_code": "943031164"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2415 UNIVERSITY AVE STE 301",
            "city": "EAST PALO ALTO",
            "state": "CA",
            "postal_code": "943031148",
            "telephone_number": "650-363-4030"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRADLEY",
        "first_name": "INDIA",
        "middle_name": "GLADYES",
        "credential": "LMFT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-07-01",
        "last_updated": "2025-04-10",
        "certification_date": "2025-04-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "LMFT154215",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in East Palo Alto, CA

Sources for this page

Verify at the official NPI Registry.