Healthcare Provider Details

I. General information

NPI: 1104736420
Provider Name (Legal Business Name): BRADLEY JAMES PILKINGTON
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/09/2026
Last Update Date: 09/09/2026
Certification Date: 09/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1201 SHAFFER RD. BLDG 1 SUITE 1A
SANTA CRUZ CA
95060
US

IV. Provider business mailing address

1201 SHAFFER RD. BLDG 1 SUITE 1A
SANTA CRUZ CA
95060
US

V. Phone/Fax

Practice location:
  • Phone: 831-420-0120
  • Fax: 831-420-1057
Mailing address:
  • Phone: 831-420-0120
  • Fax: 831-420-1057

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code372600000X
TaxonomyAdult Companion
License Number
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: