Active NPI
Danielle Bautista, A.N.P.
- Adult Health Nurse Practitioner
- Redwood City, CA
National Provider Identifier
1184969651
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Adult Health Nurse Practitioner
- License
- 2012013516
- 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
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 |
|---|---|---|---|---|
| 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
| License | State | Type | Specialty |
|---|---|---|---|
| 2012013516 | CA | MD | Adult 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.