Nancy Ivette Bautista, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

79400 Issued in CA

Practice address

1818 W Beverly Blvd Ste 207
Montebello, CA 90640-3968

Phone

(562) 385-5532

NPI assigned

Nov 15, 2012

Sex

Female

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

Enrolled in CA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

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.

• Sud Specialty Group - Ca

  dba Rula Health

  • Addiction Medicine (Psychiatry & Neurology) Physician
  • Santa Clara, CA
  • NPI 1972138238
  Medicare reassignment

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

{
    "created_epoch": "1352937600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1645660800000",
    "number": "1508100629",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1818 W BEVERLY BLVD STE 207",
            "city": "MONTEBELLO",
            "state": "CA",
            "postal_code": "906403968",
            "telephone_number": "562-385-5532"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1818 W BEVERLY BLVD STE 207",
            "city": "MONTEBELLO",
            "state": "CA",
            "postal_code": "906403968",
            "telephone_number": "562-385-5532"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BAUTISTA",
        "first_name": "NANCY",
        "middle_name": "IVETTE",
        "name_prefix": "Ms.",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-11-15",
        "last_updated": "2022-02-24",
        "certification_date": "2022-02-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "79400",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Gilbert Joseph Barajas, D.D.S.
• Roberto Barajas, PTA
• Bardi-Pak Dental Corporation (RootVision Endo)
• Elizabeth Garcia Barragan, LMFT
• Clarissa Rae Barraza
• Bay Rehabilitation Inc
• Bella Vista Multi Specialty Medical Group Inc
• Michelle Niku Bensoussan, PA-C
• Patricia Beristain
• Ross Albert Berliner, DPM

• Clinical Social Worker in Montebello, CA
• Providers in Montebello, CA by specialty
• Clinical Social Worker in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 24, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.