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Contact Information

JOHN E BRADSHAW
100 S ELLSWORTH AVE
#802
SAN MATEO, CA94401
 Phone: 650-343-6955
 Fax: 650-343-6981
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Psychologist

103T00000X 62 Psychologist, Clinical
 

Marriage & Family Therapist

106H00000X
Indicates primary specialty

NPI Profile & details for JOHN E BRADSHAW · (Male)

NPI # 1144395815
Status Active
Credentials
Entity Individual
Enumeration date 11/21/2006
Last updated 03/10/2009 - About 17 years ago
Sole proprietor 1 Yes
Identifiers
  • CA License # MFC13763
  • CA License # PSY79550
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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