KENYA DENISE BRADLEY (NPI# 1922578590) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1922578590 |
| Entity Type | Individual |
| Full Name | KENYA DENISE BRADLEY |
| Practice Address |
401 S Tustin St Orange CA 92866 |
| Practice Telephone | 7143614860 |
| Mailing Telephone | 7143614860 |
| Enumeration Date | 2018-11-27 |
| Last Update Date | 2018-11-27 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 175T00000X | Peer Specialist | Other Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1275895757 | Kenya Bradley | Specialist | 897 Lorenz Ave, North Baldwin, NY 11510-2822 | 2012-06-11 |
| Street Address |
401 S TUSTIN ST |
| City | ORANGE |
| State | CA |
| Zip Code | 92866 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1407056880 | Lily Thanh Hoang | Community Based Residential Treatment Facility, Mental Illness | 401 S Tustin St, Bldg. D, Orange, CA 92866-2550 | 2007-07-23 |
| 1992348767 | Janice Jones | Peer Specialist | 401 S Tustin St, Orange, CA 92866-2550 | 2019-10-23 |
| 1467920561 | Jason Stentz | Peer Specialist | 401 S Tustin St, Orange, CA 92866-2550 | 2018-11-06 |
| 1669959292 | Orlando Vera | Peer Specialist | 401 S Tustin St, Orange, CA 92866-2550 | 2018-07-26 |
| 1447745088 | Antoine Jackson | Counselor | 401 S Tustin St, Orange, CA 92866-2550 | 2018-06-26 |
| 1790286797 | Jesus Torres Jr. | Peer Specialist | 401 S Tustin St, Orange, CA 92866-2550 | 2018-02-24 |
| 1962903971 | Matthew Taylor | Peer Specialist | 401 S Tustin St, Orange, CA 92866-2550 | 2018-02-24 |
| 1114466331 | Maritza Meza | Counselor | 401 S Tustin St, Building D, Orange, CA 92866-2550 | 2017-02-21 |
| 1750831889 | College Community Services | Health Maintenance Organization | 401 S Tustin St, Building #c, Orange, CA 92866-2550 | 2016-10-13 |
| 1962951913 | Alvaro Sosa | Counselor | 401 S Tustin St, Bldg. D, Orange, CA 92866-2550 | 2016-09-30 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1386277499 | Jessica Hsu, M.d.,inc | Dermatology | 1506 Chapman Avenue, Address Line 2, Orange, CA 92866 | 2020-02-17 |
| 1477114122 | Beverley P Brownell | Nurse Practitioner | 1215 E. Chapman Avenue, Orange, CA 92866 | 2019-06-24 |
| 1528539442 | Brian Chau | Pharmacist | 1538 E. Chapman Ave, Orange, CA 92866 | 2018-12-17 |
| 1891214599 | Nancy Lee Mcdonald | Registered Nurse | 700 Sout Tustin, Orange, CA 92866 | 2017-09-13 |
| 1962932541 | Hao Phu Nguyen | Counselor | 401 S. Tustin Street, Building D, Orange, CA 92866 | 2017-06-15 |
| 1932567377 | Lori Lynn Hughes | Psychologist | 734 E. Chapman Ave., Suite 734, Orange, CA 92866 | 2016-01-30 |
| 1417291360 | Lori Ann Bartczak | Speech-Language Pathologist | 393 S. Tustin St., Orange, CA 92866 | 2012-11-15 |
| 1497046064 | Pacific Shore Surgery Center | Clinic/Center | 302 W. Laveta Ave, Suite 100, Orange, CA 92866 | 2011-04-29 |
| 1871805127 | Spring Medley Peavy | Nurse Practitioner | 1040 E. Chapman Ave, Orange, CA 92866 | 2010-07-01 |
| 1790956084 | Kevin Robert Franks | Dentist | 532 E Chapman Ave, Orange, CA 92866 | 2008-03-14 |
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| Taxonomy Code | 175T00000X |
| Grouping | Other Service Providers |
| Classification | Peer Specialist |
| Individuals certified to perform peer support services through a training process defined by a government agency, such as the Department of Veterans Affairs or a state mental health department/certification/licensing authority. |
| Notes: Source: National Uniform Claim Committee [7/1/2014: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1700437571 | Edith Silva | Peer Specialist | 131 W Main St Ste 101, Orange, MA 01364-1157 | 2019-09-24 |
| 1386110690 | Tara Nicole Pitterson | Peer Specialist | 401 S Tustin Street, Building C, Orange, CA 92866-2550 | 2018-10-15 |
| 1255975801 | Alycia Grace Wallace | Peer Specialist | 401 S Tustin St Bldg C, Orange, CA 92866-2550 | 2019-11-06 |
| 1992348767 | Janice Jones | Peer Specialist | 401 S Tustin St, Orange, CA 92866-2550 | 2019-10-23 |
| 1871143529 | James Michael Plaza | Peer Specialist | 131 W Main St, Orange, MA 01364-1150 | 2019-09-15 |
| 1699238444 | David Hao Tien | Peer Specialist | 401 S Tustin St Bldg C, Orange, CA 92866-2550 | 2019-04-09 |
| 1467920561 | Jason Stentz | Peer Specialist | 401 S Tustin St, Orange, CA 92866-2550 | 2018-11-06 |
| 1669959292 | Orlando Vera | Peer Specialist | 401 S Tustin St, Orange, CA 92866-2550 | 2018-07-26 |
| 1861998882 | Daniel Edmund Verdugo | Peer Specialist | 401 S Tustin St Bldg C, Orange, CA 92866-2550 | 2018-03-30 |
| 1578064457 | Alejandra Lizett Guevara | Peer Specialist | 401 S Tustin St Bldg C, Orange, CA 92866-2550 | 2018-02-26 |
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| 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.