Active NPI
Gema Bautista
- Clinical Social Worker
- Northridge, CA
National Provider Identifier
1235520305
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- Practice address
- 8550 Balboa Blvd Ste 216
Northridge, CA 91325 - Phone
- (818) 739-5160
- Fax
- (818) 739-5511
- NPI assigned
- Feb 11, 2015
- 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 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Rehabilitation Practitioner | 225400000X | |||
| Student in an Organized Health Care Education/Training Program | 390200000X | |||
| Clinical Social Worker | 1041C0700X | Primary |
Addresses
Primary practice location
8550 Balboa Blvd Ste 216
Northridge, CA 91325
Mailing address
8550 Balboa Blvd Ste 216
Northridge, CA 91325-3590
Phone (818) 739-5160
Other practice location 1
210 S De Lacey Ave Ste 110
Pasadena, CA 91105-2074
Phone (626) 395-7100
Other practice location 2
8550 Balboa Blvd Ste 216
Northridge, CA 91325
Phone (818) 739-5160
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1423612800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1562025600000",
"number": "1235520305",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "8550 BALBOA BLVD STE 216",
"city": "NORTHRIDGE",
"state": "CA",
"postal_code": "913253590",
"telephone_number": "818-739-5160",
"fax_number": "818-739-5511"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "8550 BALBOA BLVD STE 216",
"city": "NORTHRIDGE",
"state": "CA",
"postal_code": "91325",
"telephone_number": "818-739-5160",
"fax_number": "818-739-5511"
}
],
"practiceLocations": [
{
"address_1": "210 S De Lacey Ave Ste 110",
"address_purpose": "LOCATION",
"city": "Pasadena",
"state": "CA",
"postal_code": "911052074",
"country_code": "US",
"telephone_number": "626-395-7100",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "8550 Balboa Blvd Ste 216",
"address_purpose": "LOCATION",
"city": "Northridge",
"state": "CA",
"postal_code": "91325",
"country_code": "US",
"telephone_number": "818-739-5160",
"fax_number": "818-739-5511",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "BAUTISTA",
"first_name": "GEMA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2015-02-11",
"last_updated": "2019-07-02",
"status": "A"
},
"taxonomies": [
{
"code": "225400000X",
"taxonomy_group": "",
"desc": "Rehabilitation Practitioner",
"state": null,
"license": null,
"primary": false
},
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": null,
"license": null,
"primary": false
},
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Northridge, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 2, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.