Kathleen Louise Bradley, P. T.

Primary specialty

Licensed Psychiatric TechnicianTaxonomy code 167G00000X

License

PT 30664 Issued in CA

Practice address

991 Parallel Dr
Lakeport, CA 95453

Phone

(707) 263-4338

NPI assigned

Jan 5, 2007

Last updated

Jul 8, 2007By the provider in NPPES

Sex

Female

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

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

{
    "created_epoch": "1167955200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1376690776",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "P.O. BOX 671",
            "city": "COBB",
            "state": "CA",
            "postal_code": "954260671",
            "telephone_number": "707-928-6712"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "991 PARALLEL DR",
            "city": "LAKEPORT",
            "state": "CA",
            "postal_code": "95453",
            "telephone_number": "707-263-4338"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRADLEY",
        "first_name": "KATHLEEN",
        "middle_name": "LOUISE",
        "name_prefix": "Ms.",
        "credential": "P. T.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-01-05",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "167G00000X",
            "taxonomy_group": "",
            "desc": "Licensed Psychiatric Technician",
            "state": "CA",
            "license": "PT 30664",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Donovan C Bland, MD
• Martyna Joanna Blissky
• Ellen Marie Boersma, NP
• Ronald J Botelho, M.D.
• Emmalena Ann Boyd, OD
• Stephen Peter Bradley, MD
• David L. Browning, O.D.
• Mark Louis Buehnerkemper, O.D.
• Carleene Janice Cady, NP
• Liliana Caicedo, DDS

• Licensed Psychiatric Technician in Lakeport, CA
• Providers in Lakeport, CA by specialty
• Licensed Psychiatric Technician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.