Active NPI
Stephanie Bautista
- Student in an Organized Health Care Education/Training Program
- Fullerton, CA
National Provider Identifier
1144764077
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Student in an Organized Health Care Education/Training Program
- Practice address
- 680 Langsdorf Dr
Suite 200
Fullerton, CA 92831-3702 - Phone
- (714) 953-4455
- NPI assigned
- Dec 12, 2016
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | Primary |
Addresses
Primary practice location
680 Langsdorf Dr
Suite 200
Fullerton, CA 92831-3702
Mailing address
680 Langsdorf Dr
Suite 200
Fullerton, CA 92831-3702
Phone (714) 953-4455
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Child Guidance Center, Inc. | Past | Accepting new patients |
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.
-
- Community/Behavioral Health Agency
- Fullerton, CA
- NPI 1003936311
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1481500800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1494374400000",
"number": "1144764077",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "680 LANGSDORF DR",
"address_2": "SUITE 200",
"city": "FULLERTON",
"state": "CA",
"postal_code": "928313702",
"telephone_number": "714-953-4455"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "680 LANGSDORF DR",
"address_2": "SUITE 200",
"city": "FULLERTON",
"state": "CA",
"postal_code": "928313702",
"telephone_number": "714-953-4455"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BAUTISTA",
"first_name": "STEPHANIE",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2016-12-12",
"last_updated": "2017-05-10",
"status": "A"
},
"taxonomies": [
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Fullerton, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 10, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.