Individual provider Active NPI

Jessica Bloomfield Hadley

  • Student in an Organized Health Care Education/Training Program
  • Santa Rosa, CA
National Provider Identifier
1407644891
Registry record updated Apr 28, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X
Practice address
401 Bicentennial Way
Santa Rosa, CA 95403-2149
Phone
(707) 393-4000
NPI assigned
Apr 28, 2025
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 28, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X Primary

Addresses

Primary practice location

401 Bicentennial Way
Santa Rosa, CA 95403-2149

Mailing address

1800 Lacassie Ave Apt 102
Walnut Creek, CA 94596-1005
Phone (510) 219-9202

Other names 1

  • Miss Jessica Bloomfield Buffington Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20251002001293 CA Order and Referring Only - Family PracticePractitioner - Family Practice 2769988351

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

NPI Registry JSON

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

{
    "created_epoch": "1745798400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1745798400000",
    "number": "1407644891",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1800 LACASSIE AVE APT 102",
            "city": "WALNUT CREEK",
            "state": "CA",
            "postal_code": "945961005",
            "telephone_number": "510-219-9202"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "401 BICENTENNIAL WAY",
            "city": "SANTA ROSA",
            "state": "CA",
            "postal_code": "954032149",
            "telephone_number": "707-393-4000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HADLEY",
        "first_name": "JESSICA",
        "middle_name": "BLOOMFIELD",
        "name_prefix": "Mrs.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2025-04-28",
        "last_updated": "2025-04-28",
        "certification_date": "2025-04-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JESSICA",
            "last_name": "BUFFINGTON",
            "middle_name": "BLOOMFIELD",
            "prefix": "MISS",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Santa Rosa, CA

Sources for this page

Verify at the official NPI Registry.