Active NPI
Emily Bautista
- Pharmacist
- Elk Grove, CA
National Provider Identifier
1366853277
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 042596
- Practice address
- 9435 Elk Grove Blvd
Elk Grove, CA 95624-5013 - Phone
- (916) 714-6955
- NPI assigned
- May 13, 2014
- 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 |
|---|---|---|---|---|
| Pharmacist | 183500000X | 042596 | CA | Primary |
Addresses
Primary practice location
9435 Elk Grove Blvd
Elk Grove, CA 95624-5013
Mailing address
5105 Surreyglen Way
Elk Grove, CA 95758-5611
Phone (916) 684-4813
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 042596 | CA | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Bel Air Market Inc | Past | Accepting new patients | |
| Bel Air Market Inc | Past | Accepting new patients |
Organizations & group practices 2
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/Retail Pharmacy
- Elk Grove, CA
- NPI 1033211420
-
- Community/Retail Pharmacy
- Yuba City, CA
- NPI 1053421719
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1399939200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1399939200000",
"number": "1366853277",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5105 SURREYGLEN WAY",
"city": "ELK GROVE",
"state": "CA",
"postal_code": "957585611",
"telephone_number": "916-684-4813"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "9435 ELK GROVE BLVD",
"city": "ELK GROVE",
"state": "CA",
"postal_code": "956245013",
"telephone_number": "916-714-6955"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BAUTISTA",
"first_name": "EMILY",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2014-05-13",
"last_updated": "2014-05-13",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "CA",
"license": "042596",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Elk Grove, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 13, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.