Teresa Bautista Hurtado, CLS/MLT

Primary specialty

Clinical Medical LaboratoryTaxonomy code 291U00000X

License

MTA-02044844 Issued in CA

Practice address

505 Penobscot Dr
Redwood City, CA 94063-4737

Phone

(855) 698-8887

NPI assigned

May 26, 2020

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

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.

• Guardant Health Screening Corp

  • Clinical Medical Laboratory
  • Redwood City, CA
  • NPI 1538857099
  NPD
• Guardant Health, Inc.

  • Clinical Medical Laboratory
  • Redwood City, CA
  • NPI 1184045619
  NPD (past)

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

{
    "created_epoch": "1590451200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1590451200000",
    "number": "1598388530",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "33527 4TH ST",
            "city": "UNION CITY",
            "state": "CA",
            "postal_code": "945872412"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "505 PENOBSCOT DR",
            "city": "REDWOOD CITY",
            "state": "CA",
            "postal_code": "940634737",
            "telephone_number": "855-698-8887"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BAUTISTA HURTADO",
        "first_name": "TERESA",
        "credential": "CLS/MLT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-05-26",
        "last_updated": "2020-05-26",
        "certification_date": "2020-05-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": "CA",
            "license": "MTA-02044844",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CALIFORNIA DEPARTMENT OF PUBLIC HEALTH",
            "identifier": "MTA-02044844",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ASCP",
            "identifier": "25707877",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Basis Diagnostics Inc.
• Theresa Bassett-McConnell
• Sherry Elizabeth Batterson, PSYD
• Eldridge Darell Batuyong, MD
• Madeline Margaret Bauer, OTR/L
• Anthony Satoya Bautista
• Danielle Bautista, A.N.P.
• Sherry Chat Bautista
• Bay Area Foot Care, Inc
• Bay Area Foot Care, Inc

• Clinical Medical Laboratory in Redwood City, CA
• Providers in Redwood City, CA by specialty
• Clinical Medical Laboratory in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 26, 2020; 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.