Individual provider Active NPI

Danielle Bautista, A.N.P.

  • Adult Health Nurse Practitioner
  • Redwood City, CA
National Provider Identifier
1184969651
Registry record updated Apr 19, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
2012013516 Issued in CA
Practice address
363 Main St
Suite C
Redwood City, CA 94063-1729
Phone
(650) 306-9490
Fax
(650) 306-0250
NPI assigned
Dec 10, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 19, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse Practitioner 363LA2200X 2012013516 CA Primary

Addresses

Primary practice location

363 Main St
Suite C
Redwood City, CA 94063-1729

Mailing address

PO Box 1848
Novato, CA 94948-1848
Phone (415) 495-2225

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)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
2012013516CAMDAdult Health Nurse Practitioner

NPI Registry JSON

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

{
    "created_epoch": "1355097600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1461024000000",
    "number": "1184969651",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1848",
            "city": "NOVATO",
            "state": "CA",
            "postal_code": "949481848",
            "telephone_number": "415-495-2225",
            "fax_number": "415-495-2228"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "363 MAIN ST",
            "address_2": "SUITE C",
            "city": "REDWOOD CITY",
            "state": "CA",
            "postal_code": "940631729",
            "telephone_number": "650-306-9490",
            "fax_number": "650-306-0250"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BAUTISTA",
        "first_name": "DANIELLE",
        "credential": "A.N.P.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-12-10",
        "last_updated": "2016-04-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "CA",
            "license": "2012013516",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Redwood City, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 19, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.