Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Boden Bradley, PA-C

Individual provider Physician Assistant · NPI 1699229112

Boden Bradley, PA-C is a Physician Assistant in Roseville, California. Works from 2 locations. Licensed in California.

Licensed in
CA
In the registry since
2016
What do these letters mean?
PA-C — Physician Assistant, Certified
A physician assistant who holds current national certification.

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Practice location Address checks out

3005 Douglas Blvd Ste 105
Roseville, CA 95661-3885
Phone: (916) 742-7718
Fax: (510) 350-9190
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 2920 N Green Valley Pkwy Ste 814, Henderson, NV 89014-0409 — (702) 832-3600

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X · Licence 56390 (CA)

Record details

NPI number1699229112
Entity typeIndividual (Type 1)
GenderMale
Credentials PA-C
Sole proprietorNo
NPI enumeratedAugust 12, 2016
Last updated in NPPESJune 15, 2021
Certification dateJune 15, 2021

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