Jonathan Bradley

Primary specialty

Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X

Practice address

4001 King Ave
Corcoran, CA 93212-9611

Phone

(559) 992-8800

NPI assigned

Nov 11, 2025

Last updated

Nov 11, 2025By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Practice roles

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

• Corrections and Rehabilitation-Headquarters

  dba Corcoran State Prison Hospital Pharmacy

  • Pharmacy
  • Corcoran, CA
  • NPI 1376190876
  NPD
• CSP-Corcoran

  • Case Management Agency
  • Corcoran, CA
  • NPI 1265772198
  NPD (past)

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

{
    "created_epoch": "1762819200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1762819200000",
    "number": "1104796481",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1201 2ND ST",
            "city": "WASCO",
            "state": "CA",
            "postal_code": "932801310",
            "telephone_number": "661-910-6662"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4001 KING AVE",
            "city": "CORCORAN",
            "state": "CA",
            "postal_code": "932129611",
            "telephone_number": "559-992-8800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRADLEY",
        "first_name": "JONATHAN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2025-11-11",
        "last_updated": "2025-11-11",
        "certification_date": "2025-11-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "CA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Brittany Danielle Blowers, ASW
• Carolyn Virginia Bola, PSYD
• Roberto Carlos Bonilla, MD
• Harland Travis Boreen, PSYD
• Catherine Angeli Bradish, MA
• Thomas James Burket II, LCSW
• California Department of Corrections and Rehabiliations
• California Substance Abuse Treatment Facility-State Prison
• Tifani Jill Carlsen, PPS
• Anthony Valdez Casillas

• Student in an Organized Health Care Education/Training Program in Corcoran, CA
• Providers in Corcoran, CA by specialty
• Student in an Organized Health Care Education/Training Program in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 11, 2025; 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.