Thaddeaus Wayne Bush Sr., CATC

Primary specialty

CounselorTaxonomy code 101Y00000X

License

B0411260821 Issued in CA

Practice address

500 W. Hospital Rd.
Recovery House
French Camp, CA 95231

Phone

(209) 468-6857

Fax

(209) 468-6739

NPI assigned

Sep 19, 2007

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Mr. Thaddaeus Wayne Bush Other name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1190160000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1508716800000",
    "number": "1316133705",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1212 N. CALIFORNIA ST.",
            "address_2": "SAN JOAQUIN COUNTY BEHAVIORAL HEALTH",
            "city": "STOCKTON",
            "state": "CA",
            "postal_code": "95202",
            "telephone_number": "209-468-6857",
            "fax_number": "209-468-6739"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 W. HOSPITAL RD.",
            "address_2": "RECOVERY HOUSE",
            "city": "FRENCH CAMP",
            "state": "CA",
            "postal_code": "95231",
            "telephone_number": "209-468-6857",
            "fax_number": "209-468-6739"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BUSH",
        "first_name": "THADDEAUS",
        "middle_name": "WAYNE",
        "name_prefix": "Mr.",
        "name_suffix": "Sr.",
        "credential": "CATC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-09-19",
        "last_updated": "2017-10-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "CA",
            "license": "B0411260821",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "THADDAEUS",
            "last_name": "BUSH",
            "middle_name": "WAYNE",
            "prefix": "MR.",
            "credential": "CATC",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Robert Burke, P.T.
• Cecilia Burkhardt, R.N.
• Whitney Burnett, PA-C
• Jon A. Bursek, P.A.
• Yolanda Y Busby, LVN
• Javier Armando Bustamante, MD
• Lucy Butler, P.A.
• Veronica Butler
• Rasvin Buttar, N.P.
• Stephanie Marie Cabrera

• All providers in French Camp, CA
• Counselor in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 23, 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.

Verify at the official NPI Registry.