Monique Bautista, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

115289 Issued in CA

Practice address

6101 Cherry Ave
Fontana, CA 92336-5362

Phone

(909) 202-8361

NPI assigned

May 16, 2023

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

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

Specialty

Clinical Social Worker

Education

Other, 2020

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

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 and National Provider Directory roles.

• Sud Specialty Group - Ca

  • Addiction Medicine (Psychiatry & Neurology) Physician
  • Santa Clara, CA
  • NPI 1972138238

  Clinical

  Medicare reassignment NPD
• Edge Therapy and Life Coaching

  • Clinical Social Worker
  • Oklahoma City, OK
  • NPI 1982495925
  NPD Authorized official

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

{
    "created_epoch": "1684195200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783382400000",
    "number": "1033800560",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5036 SNOWBERRY DR",
            "city": "FONTANA",
            "state": "CA",
            "postal_code": "923360759",
            "telephone_number": "323-480-3177"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6101 CHERRY AVE",
            "city": "FONTANA",
            "state": "CA",
            "postal_code": "923365362",
            "telephone_number": "909-202-8361"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3616 N Meridian Ave Ste 111",
            "address_purpose": "LOCATION",
            "city": "Oklahoma City",
            "state": "OK",
            "postal_code": "731122814",
            "country_code": "US",
            "telephone_number": "909-202-8403",
            "fax_number": "909-697-2887",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BAUTISTA",
        "first_name": "MONIQUE",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-05-16",
        "last_updated": "2026-07-07",
        "certification_date": "2026-07-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "115289",
            "primary": true
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Social Worker, Clinical",
            "state": "OK",
            "license": "22588",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Susan A Baughman, CRNA
• Brian Glenn Bautista, MD
• Christine G Bautista, NP
• Jennifer S. Bautista, MD
• Mikaela Bautista
• Veronica Bautista, DO
• Vicki Lynn Beane, OTR L
• Shonda Beard, ASW
• Alfonso Becerra Jr., PHYSICIAN ASSISTANT
• Azucena Becerra

• Clinical Social Worker in Fontana, CA
• Providers in Fontana, CA by specialty
• Clinical Social Worker in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 7, 2026; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.