Mary-Jo Bautista, M.A.

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

PSY 28789 Issued in CA

Practice address

13715 Via del Palma Ave
Apt G
Whittier, CA 90602-2325

Phone

(808) 292-5693

NPI assigned

Sep 14, 2012

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Arts

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Spencer Scott Psychologist Corp

  • Clinical Psychologist
  • North Hollywood, CA
  • NPI 1194249292
  Medicare reassignment NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1347580800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1480896000000",
    "number": "1003166380",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13715 VIA DEL PALMA AVE",
            "address_2": "APT G",
            "city": "WHITTIER",
            "state": "CA",
            "postal_code": "906022325",
            "telephone_number": "808-292-5693"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13715 VIA DEL PALMA AVE",
            "address_2": "APT G",
            "city": "WHITTIER",
            "state": "CA",
            "postal_code": "906022325",
            "telephone_number": "808-292-5693"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BAUTISTA",
        "first_name": "MARY-JO",
        "credential": "M.A.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-09-14",
        "last_updated": "2016-12-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CA",
            "license": "PSY 28789",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Bassim a Salha (Natural Healing Therapies)
• Alexis Basulto
• Jennifer Karina Basulto, MSW, ASW
• Beena Batla, M.D.
• Mariel Balot Bautista, NP
• Liza Bayan, FNP
• Be a Light Enterprises LLC (Starlight Home Care)
• Be Heard Speech Therapy, Inc.
• Crystal Bebo
• Becerra Marriage Family and Child Therapy

• Clinical Psychologist in Whittier, CA
• Providers in Whittier, CA by specialty
• Clinical Psychologist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 5, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.