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BODEN BRADLEY PA-C
NPI 1699229112
Physician Assistant in Roseville, CA

Active since August 12, 2016
3005 DOUGLAS BLVD STE 105, ROSEVILLE, CA 95661(916) 742-7718(510) 350-9190 Get Directions Write a Review

NPPES record last updated: June 15, 2021. Verified against the NPPES registry weekly; last sync: July 26, 2026.

Record update history: Jun 15, 2021, May 24, 2021, Dec 30, 2020 and 3 more (6 updates tracked since 2016).

About Boden Bradley Pa-c NPPES

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

BODEN BRADLEY PA-C (NPI 1699229112) is an individual physician assistant in Roseville, California, licensed in California (56390) and active in the NPI registry since August 2016. He maintains a secondary practice location in Henderson.

NPPES Registry Identity

NPI1699229112
Entity TypeIndividualMale
Primary Taxonomy363A00000X
Provider Legal NameBODEN BRADLEYCredential: PA-C
Location Address3005 DOUGLAS BLVD STE 105Roseville, CA 95661-3885
Mailing Address3005 Douglas Blvd Ste 105Roseville, CA 95661-3885 · (916) 742-7718
Phone(916) 742-7718
Fax(510) 350-9190
Sole ProprietorNo
Enumeration DateAugust 12, 2016
Last NPPES UpdateJune 15, 20216 updates tracked since enumeration
NPPES CertifiedJune 15, 2021
✔ NPI 1699229112 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPhysician AssistantPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363A00000X
License✔ Licensed in CA · 56390
Definition

A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician.

3005 DOUGLAS BLVD STE 105, Roseville, CA 95661
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Secondary Practice Location 1

Location 12920 N Green Valley Pkwy Ste 814Henderson, NV 89014-0409 · Phone (702) 832-3600 · Fax (702) 832-5733

Other Providers at the Same Location NPPES 2

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

ROSEANNA PAULI BAINS PA-C
Physician Assistant
3005 DOUGLAS BLVD STE 105
ROSEVILLE, CA 95661
Placer County (916) 742-7718
TAYLOR DAYNE HILL PA-C
Physician Assistant
3005 DOUGLAS BLVD STE 105
ROSEVILLE, CA 95661
Placer County (916) 742-7718

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 Boden Bradley's NPI number?

The NPI number for Boden Bradley is 1699229112. It was assigned to this individual provider in the NPPES registry on August 12, 2016.

Where is Boden Bradley located?

Boden Bradley practices at 3005 Douglas Blvd Ste 105, Roseville, CA 95661. The listed phone number is (916) 742-7718.

What is Boden Bradley's specialty?

The primary specialty registered for this NPI is Physician Assistant with taxonomy code 363A00000X.

When was this NPI record last updated?

The NPPES record for Boden Bradley was last updated on June 15, 2021. NPI Profile syncs with the weekly NPPES data releases published by CMS.