Healthcare Provider Details

I. General information

NPI: 1578584223
Provider Name (Legal Business Name): MARIA ELIZABETH BELOY BRADLEY PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: MARIA ELIZABETH BELOY BRADLEY PA-C, MPAS, MPH, MD,

II. Dates (important events)

Enumeration Date: 07/21/2006
Last Update Date: 05/14/2026
Certification Date: 05/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5 BON AIR RD STE 11794929
LARKSPUR CA
94939-1143
US

IV. Provider business mailing address

600 HOSKING AVE APT 37D
BAKERSFIELD CA
93307-5731
US

V. Phone/Fax

Practice location:
  • Phone: 415-448-1500
  • Fax:
Mailing address:
  • Phone: 509-594-1135
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License NumberPA60030912
License Number StateWA
# 2
Primary TaxonomyN
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number354518-8906
License Number StateUT
# 3
Primary TaxonomyN
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number354518-1206
License Number StateUT
# 4
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License NumberPA17041
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: