Provider Demographics
NPI:1063298081
Name:BRADFORD MATTHEWS, ZONYA CRYSTAL LOLETIA
Entity type:Individual
Prefix:
First Name:ZONYA
Middle Name:CRYSTAL LOLETIA
Last Name:BRADFORD MATTHEWS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:ZONYA
Other - Middle Name:CRYSTAL
Other - Last Name:BRADFORD
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:3117 WILSON RD
Mailing Address - Street 2:
Mailing Address - City:BAKERSFIELD
Mailing Address - State:CA
Mailing Address - Zip Code:93304-5319
Mailing Address - Country:US
Mailing Address - Phone:661-324-4756
Mailing Address - Fax:
Practice Address - Street 1:3117 WILSON RD
Practice Address - Street 2:
Practice Address - City:BAKERSFIELD
Practice Address - State:CA
Practice Address - Zip Code:93304-5319
Practice Address - Country:US
Practice Address - Phone:661-324-4756
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-09-05
Last Update Date:2023-09-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program