Katherine Lynnette Bautista

Primary specialty

Behavior TechnicianTaxonomy code 106S00000X

Practice address

3443 Lilly Rd NE
Olympia, WA 98506-3091

Phone

(360) 456-2237

NPI assigned

Mar 12, 2024

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Practice roles

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.

• South Sound Behavior Therapy Corp

  • Community/Behavioral Health Agency
  • Olympia, WA
  • NPI 1306184593
  NPD (past)

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

{
    "created_epoch": "1710201600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1710201600000",
    "number": "1548028640",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1200 CONCORD AVE STE 185",
            "city": "CONCORD",
            "state": "CA",
            "postal_code": "945204915"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3443 LILLY RD NE",
            "city": "OLYMPIA",
            "state": "WA",
            "postal_code": "985063091",
            "telephone_number": "360-456-2237"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BAUTISTA",
        "first_name": "KATHERINE",
        "middle_name": "LYNNETTE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-03-12",
        "last_updated": "2024-03-12",
        "certification_date": "2024-03-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jacob Howard Bauer, M.D.
• John Mark Bauer, MD
• Laura Flores Bauleke, MD
• Roxanne Bauman, MD
• Tracie Bauman, LMP
• Patricia M Baxer, ARNP
• Bay Center Chiropractic Clinic
• Maile Bay, JD, PSYD, MSCP
• BD Olympia I, LLC
• Stephanie L Beall, LMHC

• Behavior Technician in Olympia, WA
• Providers in Olympia, WA by specialty
• Behavior Technician in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 12, 2024; 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.