Alexander Wafic Baradei, MD
Individual provider Active NPI Psychiatry Physician · Stockton, CA
NPI 1053935775 · NPPES record last updated Jul 14, 2025
Key facts
- NPI
- 1053935775
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Psychiatry Physician 2084P0800X
- License
- A200079 (CA)
- Practice address
- 1805 N California St Ste 201
Stockton, CA 95204-6032 - Phone
- (209) 645-4005
- Fax
- (209) 645-6344
- NPI assigned
- May 29, 2020
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 13
Hospital & facility affiliations 1
Medicare Care Compare profile
- Specialty
- Psychiatry
- Education
- Florida State University College of Medicine, 2020
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Touro University Medical Group
Alameda Health System
Practice addresses (Care Compare)
1805 N California St
Suite 201
Stockton, CA 95204-6032
Phone (209) 943-2000
2060 Fairmont Dr
Castro Valley, CA 94578-1001
Phone (510) 346-7500
Hospital & facility affiliations
- St Joseph'S Medical Center of Stockton
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled (2 enrollments) in SC, CA
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20240612001947 | SC | Practitioner - Psychiatry | 3971922055 | Reassigns benefits to 1 organization |
| I20250508002691 | CA | Practitioner - Psychiatry | 3971922055 | Reassigns benefits to 2 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| A200079 | CA | MD | Psychiatry Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Touro University Medical Group | Internal Medicine | Current |
Accepting new patients |
| River Region Psychiatry Associates LLC | Psychiatry | Current |
Accepting new patients |
Locations
233 Winton M Blount Loop
Montgomery, AL 36117
Phone (334) 207-3188
1805 N California St
Ste 201
Stockton, CA 95204
Phone (209) 479-3900
1315 Roberts St
Camden, SC 29020
Phone (803) 432-4311
Interoperability endpoints
- https://fhir-myrecord.cerner.com/r4/e0d732aa-1d5c-42bf-b672-8fabe3feb437/
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | LL84152 | SC | |
| Internal Medicine Physician | 207R00000X | A200079 | CA | |
| Psychiatry Physician | 2084P0800X | A200079 | CA | Yes |
Addresses
Primary practice location
1805 N California St Ste 201
Stockton, CA 95204-6032
Mailing address
35 Folly Road Blvd Unit 201
Charleston, SC 29407-2596
Phone (678) 778-9634
Other practice location 1
169 Ashley Avenue Room 202 Main Hospital MSC333
Charleston, SC 29425-8905
Phone (843) 791-0192
Other practice location 2
2100 Charlie Hall Blvd
Charleston, SC 29414-8905
Phone (843) 852-4100
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1760596480 | Medicaid | SC | |
| 1053935775 | Medicaid | CA |
Other providers in Stockton, CA
- Ashly Banos
- Sanjeev Kumar Bansal
- Vijaya Bansal
- Diana Citlali Banuelos Loreto
- Zina Antranette Baptist
- Noemi Nallely Barajas Sanchez
- Analise Barajas
- Annabel Barajas
- Carmen Barajas
- Dennis Alexsi Barajas
All providers in Stockton, CA · Psychiatry Physician in California
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 14, 2025. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.