DR. ELISE BALDWIN BRADLEY PH.D.
NPI 1295120491
Clinical Neuropsychologist in San Diego, CA

Q: What is Elise Bradley's NPI number?

The NPI number for Elise Bradley is 1295120491. It was assigned to this individual provider in the NPPES registry on April 3, 2015.

Q: What is Elise Bradley's specialty?

The primary specialty registered for this NPI is Clinical Neuropsychologist with taxonomy code 103G00000X.

Q: Is Elise Bradley enrolled in Medicare?

No. Elise Bradley has opted out of Medicare through January 7, 2027. Care is provided under private contracts, and Medicare does not pay for services furnished by providers who have opted out.

Q: When was this NPI record last updated?

The NPPES record for Elise Bradley was last updated on March 12, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.

Active since April 03, 2015Opted out of Medicare · through Jan 7, 2027

12526 HIGH BLUFF DRIVE SUITE, SUITE 300, SAN DIEGO, CA 92130(858) 314-8335(855) 706-2056 Get Directions Write a Review

NPPES record last updated: March 12, 2021. Verified against the NPPES registry weekly; last sync: August 16, 2026.

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About Dr. Elise Baldwin Bradley Ph.d. NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DR. ELISE BALDWIN BRADLEY PH.D. (NPI 1295120491) is an individual clinical neuropsychologist in San Diego, California, licensed in California (32335) and active in the NPI registry since April 2015. She has opted out of Medicare through January 7, 2027.

NPPES Registry Identity

NPI1295120491

Entity TypeIndividualFemale

Primary Taxonomy103G00000X

Provider Legal NameDR. ELISE BALDWIN BRADLEYCredential: PH.D.

Location Address12526 HIGH BLUFF DRIVE SUITE, SUITE 300San Diego, CA 92130

Mailing Address4653 Carmel Mountain Rd, Suite 308 #232San Diego, CA 92130 · (858) 314-8335

Phone(858) 314-8335

Fax(855) 706-2056

Sole ProprietorNo

Enumeration DateApril 3, 2015

Last NPPES UpdateMarch 12, 2021

NPPES CertifiedFebruary 17, 2021

✔ NPI 1295120491 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyClinical NeuropsychologistBehavioral Health & Social Service Providers

Taxonomy Code103G00000X

Licenses✔ Licensed in CA · 32335✔ Licensed in TN · P0000003132

Definition

A clinical psychologist who applies principles of assessment and intervention based upon the scientific study of human behavior as it relates to normal and abnormal functioning of the central nervous system. The specialty is dedicated to enhancing the understanding of brain-behavior relationships and the application of such knowledge to human problems.

Also ListedPsychologist · ClinicalTaxonomy 103TC0700X · License P0000003132 (TN), 32335 (CA)

12526 HIGH BLUFF DRIVE SUITE, San Diego, CA 92130

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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

ⓘ

Opted out of Medicare

Dr. Elise Baldwin Bradley Ph.d. has filed a Medicare opt-out affidavit. Services are provided under private contract between the provider and the patient, and are not billed to or reimbursed by Medicare. The opt-out is on file from January 7, 2023 through January 7, 2027.

Opt-Out Effective DateJanuary 7, 2023

Opt-Out In Effect ThroughJanuary 7, 2027Opt-out affidavits renew automatically every two years unless cancelled

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Elise Bradley's NPI number?

The NPI number for Elise Bradley is 1295120491. It was assigned to this individual provider in the NPPES registry on April 3, 2015.

Where is Elise Bradley located?

Elise Bradley practices at 12526 High Bluff Drive Suite Suite 300, San Diego, CA 92130. The listed phone number is (858) 314-8335.

What is Elise Bradley's specialty?

The primary specialty registered for this NPI is Clinical Neuropsychologist with taxonomy code 103G00000X.

Is Elise Bradley enrolled in Medicare?

No. Elise Bradley has opted out of Medicare through January 7, 2027. Care is provided under private contracts, and Medicare does not pay for services furnished by providers who have opted out.

When was this NPI record last updated?

The NPPES record for Elise Bradley was last updated on March 12, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.