Brian K Bradley, AII2201214

Primary specialty

Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X

License

AII2201214 Issued in CA

Practice address

2212 N Winery Ave
Fresno, CA 93703-2896

Phone

(559) 600-9168

NPI assigned

Dec 16, 2018

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1544918400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1544918400000",
    "number": "1104397348",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "515 S CEDAR AVE",
            "city": "FRESNO",
            "state": "CA",
            "postal_code": "937022908",
            "telephone_number": "559-600-9168"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2212 N WINERY AVE",
            "city": "FRESNO",
            "state": "CA",
            "postal_code": "937032896",
            "telephone_number": "559-600-9168"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "515 S Cedar Ave",
            "address_purpose": "LOCATION",
            "city": "Fresno",
            "state": "CA",
            "postal_code": "937022908",
            "country_code": "US",
            "telephone_number": "559-600-9168",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BRADLEY",
        "first_name": "BRIAN",
        "middle_name": "K",
        "credential": "AII2201214",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2018-12-16",
        "last_updated": "2018-12-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "CA",
            "license": "AII2201214",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jared Bradford, PTA
• Sean Bradford
• Tanika Charmaine Bradford
• Catherine Angeli Bradish
• Bradley Counseling Centers Licensed Clinical Social Worker Corporation
• Emily Colleen Bradley
• Flora Elsa Lina Claudine Bradley, MD
• Ricky Bradley
• Sallie M. Bradley, LCSW
• Vannessa Miles Bradley

• Addiction (Substance Use Disorder) Counselor in Fresno, CA
• Providers in Fresno, CA by specialty
• Addiction (Substance Use Disorder) Counselor in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 16, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.