STANLEY BRAGG JR.


Address: 6119 Montecito Blvd Apt 12, Santa Rosa, CA 95409-2969
Phone: 7078882592

STANLEY BRAGG JR. (NPI# 1013368083) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1013368083
Entity Type Individual
Full Name STANLEY BRAGG JR.
Practice Address 6119 Montecito Blvd Apt 12
Santa Rosa
CA 95409-2969
Practice Telephone 7078882592
Mailing Telephone 7078882592
Enumeration Date 2016-06-30
Last Update Date 2016-06-30
Gender Code M
Is Sole Proprietor N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 101YA0400X Counselor
Specialization: Addiction (Substance Use Disorder)
7744-R CA Behavioral Health & Social Service Providers

Other Provider Identifier

State Issuer Identifier Type Code
CA SUBSTANCE ABUSE COUNSELOR 7744-R 01

Office Location

Street Address 6119 MONTECITO BLVD APT 12
City SANTA ROSA
State CA
Zip Code 95409-2969

Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1568005205 Angela Tejeda Counselor 35555 Sonoma Hwy, Santa Rosa, CA 95409 2019-10-25
1609335314 Heidi Diebel Marriage & Family Therapist 9291 Oak Trail Cir, Santa Rosa, CA 95409 2019-03-13
1427525328 Christopher William Schouest Behavioral Analyst 5424 Sharon St., Santa Rosa, CA 95409 2018-10-29
1194178756 Ana Ceniceros Registered Nurse 7425 Los Guilucos Rd, Santa Rosa, CA 95409 2016-07-19
1669842878 Kimberly Harris Counselor 7425 Los Guilicos Rd., Dept. H, Santa Rosa, CA 95409 2015-09-30
1568884849 Christopher Cincotta Counselor 540 Middle Rincon Road, Santa Rosa, CA 95409 2014-01-06
1104186626 Gina Ruth Sarpy Marriage & Family Therapist 7425 Los Guilicos Rd, Dept. H, Santa Rosa, CA 95409 2012-05-17
1467745950 Courtney King Family Medicine 4702 Starbuck Ave, Santa Rosa, CA 95409 2011-05-17
1427351162 Robert E Richardson Md Professional Corp. Surgery 1812 Happy Valley Road, Santa Rosa, CA 95409 2010-12-20
1497063564 Edmundo Simon Martinez IIi IIi Occupational Therapist 5555 Montgomery Dr., Santa Rosa, CA 95409 2010-09-22
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Taxonomy Information

Taxonomy Code 101YA0400X
Grouping Behavioral Health & Social Service Providers
Classification Counselor
Specialization Addiction (Substance Use Disorder)

Taxonomy Definition

Definition to come...

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1568089803 Joan Colombo Counselor 1450 Neotomas Ave, Santa Rosa, CA 95405-7537 2020-07-02
1083230486 Lizett Camacho Counselor 145o Neotomas Avenue Suite 200, Santa Rosa, CA 95405 2020-06-22
1568005205 Angela Tejeda Counselor 35555 Sonoma Hwy, Santa Rosa, CA 95409 2019-10-25
1780147538 Aimee Noelle Krzywicki Counselor 2403 Professional Dr Ste 102, Santa Rosa, CA 95403-3007 2019-04-09
1811487903 Michael Armand Maritzen Counselor 2245 Challenger Way # 100, Santa Rosa, CA 95407-5418 2018-05-14
1922520527 Robert John Lotero Counselor 7104 Oak Leaf Dr, Santa Rosa, CA 95409-6028 2017-07-14
1184153728 Amanda Christina Gomez-hernandez Counselor 2400 County Center Dr Ste B, Santa Rosa, CA 95403-3004 2017-06-07
1225577968 Kari Kenyon Counselor 1380 Wright St Apt 8, Santa Rosa, CA 95404-3437 2017-02-14
1205207321 Flaman Craig Mccloud Jr. Counselor 440 Arrowood Dr., Santa Rosa, CA 95407 2015-10-15
1124497458 Dallas Jones Counselor 2403 Professional Dr Ste 103, Santa Rosa, CA 95403-3007 2015-09-16
Find all providers in SANTA ROSA

Competitor

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City SANTA ROSA
Zip Code 95409

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Dataset Information

Data Provider Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES)
Jurisdiction Medicare & Medicaid

This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.

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