Individual provider Active NPI

Bradley Thomas Heidenberg, LMFT

  • Marriage & Family Therapist
  • Clovis, CA
National Provider Identifier
1255764627
Registry record updated Aug 12, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
98495 Issued in CA
Practice address
90 W Ashlan Ave Ste 100
Clovis, CA 93612-5627
Phone
(559) 473-1770
NPI assigned
Aug 20, 2013
Last updated
Aug 12, 2026By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 12, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family Therapist 106H00000X 98495 CA Primary

Addresses

Primary practice location

90 W Ashlan Ave Ste 100
Clovis, CA 93612-5627

Mailing address

PO Box 2087
Merced, CA 95344-0087
Phone (209) 381-6800

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

NPI Registry JSON

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

{
    "created_epoch": "1376956800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1786492800000",
    "number": "1255764627",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2087",
            "city": "MERCED",
            "state": "CA",
            "postal_code": "953440087",
            "telephone_number": "209-381-6800"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "90 W ASHLAN AVE STE 100",
            "city": "CLOVIS",
            "state": "CA",
            "postal_code": "936125627",
            "telephone_number": "559-473-1770"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HEIDENBERG",
        "first_name": "BRADLEY",
        "middle_name": "THOMAS",
        "credential": "LMFT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-08-20",
        "last_updated": "2026-08-12",
        "certification_date": "2026-08-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "98495",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Clovis, CA

Sources for this page

Verify at the official NPI Registry.