Jacquelyn J. Bradbard, MSW, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

LCS23174 Issued in CA

Practice address

9033 Baseline Rd
Suite H
Rancho Cucamonga, CA 91730-1255

Phone

(909) 989-9030

Fax

(909) 466-4594

NPI assigned

Sep 9, 2011

Sex

Female

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

Enrolled in CA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Sac Health System

  • Federally Qualified Health Center (FQHC)
  • San Bernardino, CA
  • NPI 1013935923
  Medicare reassignment NPD
• Sac Health System

  • Federally Qualified Health Center (FQHC)
  • San Bernardino, CA
  • NPI 1467274126
  NPD
• Sac Health System

  • Federally Qualified Health Center (FQHC)
  • San Bernardino, CA
  • NPI 1649547944
  NPD

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

{
    "created_epoch": "1315526400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1315526400000",
    "number": "1265714869",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9033 BASELINE RD",
            "address_2": "SUITE H",
            "city": "RANCHO CUCAMONGA",
            "state": "CA",
            "postal_code": "917301255",
            "telephone_number": "909-989-9030",
            "fax_number": "909-466-4594"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9033 BASELINE RD",
            "address_2": "SUITE H",
            "city": "RANCHO CUCAMONGA",
            "state": "CA",
            "postal_code": "917301255",
            "telephone_number": "909-989-9030",
            "fax_number": "909-466-4594"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRADBARD",
        "first_name": "JACQUELYN",
        "middle_name": "J.",
        "credential": "MSW, LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-09-09",
        "last_updated": "2011-09-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "LCS23174",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jessica Bowser, AMFT
• Michael Boyd
• Kelley Marie Boyer, PTA
• Aruna Prabha Boyineni
• Bqute Enterprises
• Hana Bradford
• Jaclyn Bradle, D.D.S.
• Brain Psychiatry Inc
• Susan K Brainard, O.T.
• Rachel Bramer

• Clinical Social Worker in Rancho Cucamonga, CA
• Providers in Rancho Cucamonga, CA by specialty
• Clinical Social Worker in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 9, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.