Individual provider Active NPI

Bradley Thomas Wajda, D.O.

  • Psychiatry Physician
  • Hanford, CA
National Provider Identifier
1639394364
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
20A5557 Issued in CA
Practice address
1393 Bailey Dr.
Hanford, CA 93230-5922
Phone
(559) 582-4481
NPI assigned
Apr 16, 2007
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X 20A5557 CA Primary

Addresses

Primary practice location

1393 Bailey Dr.
Hanford, CA 93230-5922

Mailing address

1393 Bailey Drive
Hanford, CA 93230-5922
Phone (559) 582-4481

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Opted out of Medicare
Previously, effective Aug 24, 2020 through Aug 24, 2026

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

NPI Registry JSON

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

{
    "created_epoch": "1176681600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1639394364",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1393 BAILEY DRIVE",
            "city": "HANFORD",
            "state": "CA",
            "postal_code": "932305922",
            "telephone_number": "559-582-4481"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1393 BAILEY DR.",
            "city": "HANFORD",
            "state": "CA",
            "postal_code": "932305922",
            "telephone_number": "559-582-4481"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WAJDA",
        "first_name": "BRADLEY",
        "middle_name": "THOMAS",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-04-16",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "CA",
            "license": "20A5557",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hanford, CA

Sources for this page

Verify at the official NPI Registry.