Tara Bradley, MA, OTR/L

Primary specialty

Pediatric Occupational TherapistTaxonomy code 225XP0200X

License

OT 10033 Issued in CA

Practice address

30412 Esperanza
Rancho Santa Margarita, CA 92688

Phone

(949) 459-1658

NPI assigned

Oct 15, 2010

Last updated

Oct 15, 2010By the provider in NPPES

Sex

Female

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

Credentials

Master of Arts

State licenses

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

{
    "created_epoch": "1287100800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1287100800000",
    "number": "1164732756",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15 GRACE LANE",
            "city": "COTO DE CAZA",
            "state": "CA",
            "postal_code": "92679",
            "telephone_number": "949-212-4221"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "30412 ESPERANZA",
            "city": "RANCHO SANTA MARGARITA",
            "state": "CA",
            "postal_code": "92688",
            "telephone_number": "949-459-1658"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRADLEY",
        "first_name": "TARA",
        "credential": "MA, OTR/L",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-10-15",
        "last_updated": "2010-10-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225XP0200X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist, Pediatrics",
            "state": "CA",
            "license": "OT 10033",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Scott Eugene Bianchi, D.D.S.
• Elyse Biechele, DPT
• Natalia Bilan, MD
• Luis Gustavo T Bitton, DDS
• Paige Boggess
• Jody Bremer, LMFT
• Bristol Park Medical Group, Inc.
• Justin Charles Brown, MPT
• Susan Lorraine Brown, PT
• Lechelle Brueggeman, PSYD

• Pediatric Occupational Therapist in Rancho Santa Margarita, CA
• Providers in Rancho Santa Margarita, CA by specialty
• Pediatric Occupational Therapist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 15, 2010; 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.