Fuensanta Botello, MD

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

License

A44082 Issued in CA

Practice address

1501 Fruitvale Ave
Oakland, CA 94601-2322

Phone

(510) 535-6200

Fax

(510) 535-4167

NPI assigned

Oct 25, 2006

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

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: fbotello308143@direct.ochin.org

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.

• La Clinica de la Raza Inc

  • Federally Qualified Health Center (FQHC)
  • Concord, CA
  • NPI 1538181482
  Medicare reassignment
• La Clinica de la Raza Inc

  • Federally Qualified Health Center (FQHC)
  • Oakland, CA
  • NPI 1144336181
  NPD
• La Clinica de la Raza Inc

  • Federally Qualified Health Center (FQHC)
  • Oakland, CA
  • NPI 1346262292
  NPD
• La Clinica de la Raza, Inc.

  • Federally Qualified Health Center (FQHC)
  • Oakland, CA
  • NPI 1174639116
  NPD

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

{
    "created_epoch": "1161734400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678147200000",
    "number": "1043395718",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1501 FRUITVALE AVE",
            "city": "OAKLAND",
            "state": "CA",
            "postal_code": "946012322",
            "telephone_number": "510-535-6200",
            "fax_number": "510-535-4167"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1501 FRUITVALE AVE",
            "city": "OAKLAND",
            "state": "CA",
            "postal_code": "946012322",
            "telephone_number": "510-535-6200",
            "fax_number": "510-535-4167"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOTELLO",
        "first_name": "FUENSANTA",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-25",
        "last_updated": "2023-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "CA",
            "license": "A44082",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Austin Vollmers Boswell
• Emily Rose Boswell
• Junique Shannon Boswell
• Barbara Botelho, M.D.
• Nicole Botelho
• Anerien Botha, PSYD
• Allen David Bott, MD
• Alla Bottler, RRT
• Mallak Mukatash Botto
• Patricia Katina Bottom

• Psychiatry Physician in Oakland, CA
• Providers in Oakland, CA by specialty
• Psychiatry Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2023; 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.