Michael Bradshaw

Primary specialty

Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X

License

156042 I Issued in CA

Practice address

4650 Kester Ave Apt 101
Sherman Oaks, CA 91403-2533

Phone

(818) 723-9403

NPI assigned

Jun 29, 2016

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

Practice roles

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.

• Kokua Wellness Inc.

  • Substance Use Disorder Rehabilitation Clinic/Center
  • Ventura, CA
  • NPI 1891488748
  NPD Authorized official

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

{
    "created_epoch": "1467158400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1467158400000",
    "number": "1255782496",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4650 KESTER AVE APT 101",
            "city": "SHERMAN OAKS",
            "state": "CA",
            "postal_code": "914032533",
            "telephone_number": "818-723-9403"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4650 KESTER AVE APT 101",
            "city": "SHERMAN OAKS",
            "state": "CA",
            "postal_code": "914032533",
            "telephone_number": "818-723-9403"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRADSHAW",
        "first_name": "MICHAEL",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2016-06-29",
        "last_updated": "2016-06-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "CA",
            "license": "156042 I",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jonathan D Botts, M.D.
• Portia Unique Bowden
• Sophia Ann Bowen
• Michelle Bracken, LMFT
• Katherine Bradley
• Shannon Bradshaw, AMFT
• Dennis Wayne Braga, D.C.
• Sogol Bral
• Susan Frances Bralver, M.S.W., L.C.S.W.
• Reve Brander, CRNA

• Addiction (Substance Use Disorder) Counselor in Sherman Oaks, CA
• Providers in Sherman Oaks, 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 Jun 29, 2016; 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.