Individual provider Active NPI

Emily Bautista, DC

  • Chiropractor
  • Rancho Cucamonga, CA
National Provider Identifier
1043196512
Registry record updated Aug 12, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
36933 Issued in CA
Practice address
10737 Laurel St Ste 220
Rancho Cucamonga, CA 91730-3837
Phone
(909) 244-9754
NPI assigned
Aug 12, 2025
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 12, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 36933 CA Primary

Addresses

Primary practice location

10737 Laurel St Ste 220
Rancho Cucamonga, CA 91730-3837

Mailing address

10737 Laurel St Ste 220
Rancho Cucamonga, CA 91730-3837
Phone (909) 244-9754

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20260119000743 CA Practitioner - Chiropractic 9335626506 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Life Chiropractic College - West, 2023
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

10737 Laurel St
Suite 220
Rancho Cucamonga, CA 91730-3837

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
36933CAMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Emily Ronduen Bautista Chiropractic Inc. Chiropractor CurrentSince Jan 8, 2026 Accepting new patients

Locations

10737 Laurel St
Ste 220
Rancho Cucamonga, CA 91730
Phone (909) 244-9754

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1754956800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1754956800000",
    "number": "1043196512",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10737 LAUREL ST STE 220",
            "city": "RANCHO CUCAMONGA",
            "state": "CA",
            "postal_code": "917303837",
            "telephone_number": "909-244-9754"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10737 LAUREL ST STE 220",
            "city": "RANCHO CUCAMONGA",
            "state": "CA",
            "postal_code": "917303837",
            "telephone_number": "909-244-9754"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BAUTISTA",
        "first_name": "EMILY",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-08-12",
        "last_updated": "2025-08-12",
        "certification_date": "2025-08-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "CA",
            "license": "36933",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rancho Cucamonga, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 12, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.