MEDICARE: ALYSSA CARMEN BRADLEY

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
1	225100000X	Physical Therapist		CA

General Provider Information

NPI Number	:	1235093931
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ALYSSA CARMEN BRADLEY

Provider Business Mailing Address
First Line	:	19732 MACARTHUR BLVD STE 125
Second Line	:
City	:	IRVINE
State	:	CA
Zip	:	92612-2455
Country	:	US
Telephone Number	:	949-644-2022
Fax Number	:	949-644-1914

Provider Business Practice Location Address
First Line	:	19732 MACARTHUR BLVD STE 125
Second Line	:
City	:	IRVINE
State	:	CA
Zip	:	92612-2455
Country	:	US
Telephone Number	:	949-644-2022
Fax Number	:	949-644-1914

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/16/2025
Last Update Date	:	12/16/2025

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Directions to “ ALYSSA CARMEN BRADLEY ” Practice Location

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