Individual provider Active NPI

Bradley Wolf, PSYD, LP

  • Clinical Psychologist
  • Mission Viejo, CA
National Provider Identifier
1083192801
Registry record updated Oct 8, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
34607 Issued in CA
Practice address
27401 Los Altos Ste 120
Mission Viejo, CA 92691-8580
Phone
(562) 431-8822
NPI assigned
Aug 2, 2018
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 8, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X 34607 CA Primary
Student in an Organized Health Care Education/Training Program 390200000X

Addresses

Primary practice location

27401 Los Altos Ste 120
Mission Viejo, CA 92691-8580

Mailing address

27401 Los Altos Ste 120
Mission Viejo, CA 92691-8580
Phone (562) 431-8822

Other practice location 1

1266 14th St
Oakland, CA 94607-2205
Phone (510) 273-4700

Other names 1

  • Bradley Lewis Wolf Former name

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
I20240521003937 CA Practitioner - Clinical Psychologist 8123460276 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Pacific Coast Psychiatric Associates IncGroup PAC ID 2567469174, 637 clinicians

Practice addresses (Care Compare)

27401 Los Altos
Suite 120
Mission Viejo, CA 92691-8580
Phone (562) 431-8822

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
34607CAMDCritical Care Registered Respiratory Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Permanente Medical Group, Inc CurrentSince Apr 9, 2024 Accepting new patients
Pacific Coast Psychiatric Associates Inc Clinical CurrentSince Sep 30, 2025 Accepting new patients
Permanente Medical Group Inc Current Accepting new patients
Permanente Medical Group Inc CurrentSince Apr 9, 2024 Accepting new patients

Locations

750 Auburn Ravine Rd
Auburn, CA 95603
Phone (530) 823-6131

4753 W Shaw Ave
Ste 101
Fresno, CA 93722
Phone (559) 277-8738

900 N Douty St
Hanford, CA 93230
Phone (559) 587-9014

4040 Barranca Pkwy
Ste 260
Irvine, CA 92604

27401 Los Altos
Ste 120
Mission Viejo, CA 92691
Phone (562) 614-6763

3900 Broadway
Oakland, CA 94611
Phone (510) 752-1075

101 Monroe St
Petaluma, CA 94954
Phone (707) 763-4109

1150 Veterans Blvd
Redwood City, CA 94063
Phone (650) 299-2015

901 Nevin Ave
Richmond, CA 94801
Phone (510) 307-1500

930 W Main St
Ripon, CA 95366
Phone (209) 599-4221

501 J St
Sacramento, CA 95814
Phone (916) 497-3000

2200 Ofarrell St
San Francisco, CA 94115
Phone (415) 202-2000

710 Lawrence Expy
Santa Clara, CA 95051
Phone (408) 236-6400

5615 Scotts Valley Dr
Scotts Valley, CA 95066
Phone (831) 430-2700

7373 West Ln
Stockton, CA 95210
Phone (209) 476-2000

975 Sereno Dr
Vallejo, CA 94589
Phone (707) 651-1000

320 N Crawford St
Willows, CA 95988
Phone (530) 934-2834

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": "1533168000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1759881600000",
    "number": "1083192801",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "27401 LOS ALTOS STE 120",
            "city": "MISSION VIEJO",
            "state": "CA",
            "postal_code": "926918580",
            "telephone_number": "562-431-8822"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "27401 LOS ALTOS STE 120",
            "city": "MISSION VIEJO",
            "state": "CA",
            "postal_code": "926918580",
            "telephone_number": "562-431-8822"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1266 14th St",
            "address_purpose": "LOCATION",
            "city": "Oakland",
            "state": "CA",
            "postal_code": "946072205",
            "country_code": "US",
            "telephone_number": "510-273-4700",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WOLF",
        "first_name": "BRADLEY",
        "name_prefix": "Mr.",
        "credential": "PSYD, LP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-08-02",
        "last_updated": "2025-10-08",
        "certification_date": "2025-10-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CA",
            "license": "34607",
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "BRADLEY",
            "last_name": "WOLF",
            "middle_name": "LEWIS",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Mission Viejo, CA

Sources for this page

Verify at the official NPI Registry.