Pamela N Verder Bautista, MD

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

A76841 Issued in CA

Practice address

632 W Gibson Rd
Woodland, CA 95695

Phone

(530) 666-1631

Fax

(530) 668-4839

NPI assigned

Jul 12, 2006

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

Other identifiers 2

Other names 1

• Dr. Pamela Verder Former name

Medicare fee-for-service enrollment

Enrolled in CA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1152662400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1257120000000",
    "number": "1558396028",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "632 W GIBSON RD",
            "city": "WOODLAND",
            "state": "CA",
            "postal_code": "95695",
            "telephone_number": "530-666-1631"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "632 W GIBSON RD",
            "city": "WOODLAND",
            "state": "CA",
            "postal_code": "95695",
            "telephone_number": "530-666-1631",
            "fax_number": "530-668-4839"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VERDER BAUTISTA",
        "first_name": "PAMELA",
        "middle_name": "N",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-12",
        "last_updated": "2009-11-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "CA",
            "license": "A76841",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00A768410",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD",
            "identifier": "00A768410",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "PAMELA",
            "last_name": "VERDER",
            "prefix": "DR.",
            "credential": "MD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Juvencio Vargas, D.C.
• Tarin Alisa Varughese, M.A., CCC-SLP
• Diana G Vasquez, MA
• Selena B Vega
• Valerie Venghiattis, PA
• Stacy Vernick
• Vida Counseling Inc.
• Vanessa Vidales
• Alisha Joyce Vielma
• Amanda Isabel Vierra

• Pediatrics Physician in Woodland, CA
• Providers in Woodland, CA by specialty
• Pediatrics Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 2, 2009; 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.