Ronnie Bautista, LCSW

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

96824 Issued in CA

Practice address

1195 Hudson Ave
San Francisco, CA 94124-2488

Phone

(628) 202-4825

NPI assigned

May 12, 2023

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": "1683849600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1683849600000",
    "number": "1528758406",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2443 FILLMORE ST # 380-4020",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941151814"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1195 HUDSON AVE",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941242488",
            "telephone_number": "628-202-4825"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BAUTISTA",
        "first_name": "RONNIE",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-05-12",
        "last_updated": "2023-05-12",
        "certification_date": "2023-05-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "CA",
            "license": "96824",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kenneth Bautista, OTR/L
• Laura Renee Bautista, RN
• Lord Mark Bautista
• Marianne Bautista
• Rhea Bautista
• Rosh Marguerite Marguerite Bautista, MS
• Samantha Timpog Bautista
• Victor Bautista, O.D.
• Shivali Baveja, MD
• Sanjiv M Baxi, M.D.

• Mental Health Counselor in San Francisco, CA
• Providers in San Francisco, CA by specialty
• Mental Health Counselor in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 12, 2023; 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.