Provider Demographics
NPI:1023261591
Name:BRADLEY-MOORE, MARIA DEBORAH (MD)
Entity type:Individual
Prefix:DR
First Name:MARIA
Middle Name:DEBORAH
Last Name:BRADLEY-MOORE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:815 HYDE ST
Mailing Address - Street 2:STE 100
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94109-5998
Mailing Address - Country:US
Mailing Address - Phone:415-673-5700
Mailing Address - Fax:415-292-7140
Practice Address - Street 1:815 HYDE ST STE 100
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94109-5998
Practice Address - Country:US
Practice Address - Phone:415-673-5700
Practice Address - Fax:415-292-7140
Is Sole Proprietor?:Yes
Enumeration Date:2008-10-28
Last Update Date:2017-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA1055852084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry