Active NPI
Jennifer Vradenburg-Haworth, M.D.
- Family Medicine Physician
- Reedley, CA
National Provider Identifier
1275630162
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- G74822
- Practice address
- 550 W Cypress Ave
Reedley, CA 93654-2096 - Phone
- (559) 391-3115
- Fax
- (559) 391-3117
- NPI assigned
- Sep 20, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | G74822 | CA | Primary |
Addresses
Primary practice location
550 W Cypress Ave
Reedley, CA 93654-2096
Mailing address
550 W Cypress Ave
Reedley, CA 93654-2096
Phone (559) 391-3115
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 00G748220 | Medicaid | CA |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 74822 | CA | MD | Marriage & Family Therapist |
| G74822 | CA | MD | Family Medicine Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1158710400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1501200000000",
"number": "1275630162",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "550 W CYPRESS AVE",
"city": "REEDLEY",
"state": "CA",
"postal_code": "936542096",
"telephone_number": "559-391-3115",
"fax_number": "559-391-3117"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "550 W CYPRESS AVE",
"city": "REEDLEY",
"state": "CA",
"postal_code": "936542096",
"telephone_number": "559-391-3115",
"fax_number": "559-391-3117"
}
],
"practiceLocations": [],
"basic": {
"last_name": "VRADENBURG-HAWORTH",
"first_name": "JENNIFER",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-09-20",
"last_updated": "2017-07-28",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "CA",
"license": "G74822",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "00G748220",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Reedley, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 28, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.