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NPI Code Detail

MEDICARE: VICTORIA-DEVA BRADSHAW

MEDICARE: VICTORIA-DEVA BRADSHAW
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1106S00000XBehavior TechnicianCA
2390200000XStudent in an Organized Health Care Education/Training Program

General Provider Information

NPI Number : 1114805389
Entity Type Code : Individual
Provider Name (Legal Business Name) : VICTORIA-DEVA BRADSHAW
Provider Business Mailing Address
First Line : 1664 BROADWAY
Second Line :
City : EL CAJON
State : CA
Zip : 92021-5201
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 1664 BROADWAY
Second Line :
City : EL CAJON
State : CA
Zip : 92021-5201
Country : US
Telephone Number : 619-579-8685
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/25/2025
Last Update Date : 02/20/2026

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Directions to “ VICTORIA-DEVA BRADSHAW ” Practice Location

Language Start Address Practice Location
These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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