Kenneth Bautista, RBT

Primary specialty

Behavior TechnicianTaxonomy code 106S00000X

License

RBT-21-178540 Issued in CA

Practice address

6320 Canoga Ave FL 15
Woodland Hills, CA 91367-2563

Phone

(661) 214-3063

NPI assigned

Aug 11, 2021

Sex

Male

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1628640000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1628640000000",
    "number": "1225703275",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "25350 MAGIC MOUNTAIN PKWY STE 300",
            "city": "SANTA CLARITA",
            "state": "CA",
            "postal_code": "913551356"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6320 CANOGA AVE FL 15",
            "city": "WOODLAND HILLS",
            "state": "CA",
            "postal_code": "913672563",
            "telephone_number": "661-214-3063"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "25350 Magic Mountain Pkwy Ste 300",
            "address_purpose": "LOCATION",
            "city": "Santa Clarita",
            "state": "CA",
            "postal_code": "913551356",
            "country_code": "US",
            "telephone_number": "661-214-3063",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BAUTISTA",
        "first_name": "KENNETH",
        "credential": "RBT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-08-11",
        "last_updated": "2021-08-11",
        "certification_date": "2021-08-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": "CA",
            "license": "RBT-21-178540",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Paris Debonae Batts
• Jaclyn Mayberry Bauer, PH.D.
• Carolyn Lee Baum, MSW, LCSW
• Dennis Bautista
• Jose Santos Bautista, PHARMD
• Portia Bautista
• Tennesse Bautista, RPH
• Anita Bavarsky, PSY.D.
• Rita G Baxter, CRNA
• Tsendayush Bayanbileg, NONE

• Behavior Technician in Woodland Hills, CA
• Providers in Woodland Hills, CA by specialty
• Behavior Technician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 11, 2021; 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.