Optimum Wellness Therapy

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

Legal business name

OPTIMUM WELLNESS THERAPY

Practice address

8725 S San Pedro St
Los Angeles, CA 90003-3538

Phone

(443) 996-1989

Fax

(443) 681-3434

NPI assigned

Feb 23, 2022

Organization subpart

No

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

Authorized official

Name

Kendall Ashton Bradford, LCSWNPI 1992377360

Title

Owner

Phone

(443) 996-1989

Specialties & licenses 1

Addresses

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Kendall Ashton Bradford

  • Mental Health Counselor
  • Los Angeles, CA
  • NPI 1992377360

  Clinical

  NPD Authorized official

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

{
    "created_epoch": "1645574400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1645574400000",
    "number": "1770239170",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "509 HYDE PARK PL APT 7",
            "city": "INGLEWOOD",
            "state": "CA",
            "postal_code": "903021666",
            "telephone_number": "443-996-1989",
            "fax_number": "443-681-3434"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8725 S SAN PEDRO ST",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900033538",
            "telephone_number": "443-996-1989",
            "fax_number": "443-681-3434"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OPTIMUM WELLNESS THERAPY",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-02-23",
        "last_updated": "2022-02-23",
        "certification_date": "2022-02-23",
        "status": "A",
        "authorized_official_last_name": "BRADFORD",
        "authorized_official_first_name": "KENDALL",
        "authorized_official_middle_name": "ASHTON",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "443-996-1989",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Optimum Urgent Care
• Opto Bar Optometric Inc
• Optometric Eye Institute PC
• Optometric Eyesite Inc
• Optometric Specialties Inc
• Optometrix

• Clinical Social Worker in Los Angeles, CA
• Providers in Los Angeles, CA by specialty
• Clinical Social Worker in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 23, 2022; 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.