Brenda Hernandez Bautista

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

ACSW90551 Issued in CA

Practice address

222 W 6TH St Ste 230
San Pedro, CA 90731-3332

Phone

(310) 833-3135

Fax

(310) 707-2877

NPI assigned

Jul 24, 2018

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)

Enrolled

State licenses

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.

• The Guidance Center

  • Community/Behavioral Health Agency
  • San Pedro, CA
  • NPI 1174654156
  NPD (past)

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

{
    "created_epoch": "1532390400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1651536000000",
    "number": "1649757535",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1301 PINE AVE",
            "city": "LONG BEACH",
            "state": "CA",
            "postal_code": "908133124",
            "telephone_number": "562-595-1159"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "222 W 6TH ST STE 230",
            "city": "SAN PEDRO",
            "state": "CA",
            "postal_code": "907313332",
            "telephone_number": "310-833-3135",
            "fax_number": "310-707-2877"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HERNANDEZ BAUTISTA",
        "first_name": "BRENDA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-07-24",
        "last_updated": "2022-05-03",
        "certification_date": "2022-05-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "CA",
            "license": "ACSW90551",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lauren Hellum
• Mehdi Hemmat, MD
• Henry J Ortiz PSYD Inc (Henry Ortiz PsyD)
• Herbert G Martin DDS Inc
• Herbert H Webb MD Inc
• Ana J Hernandez-Cruz, FNP-BC, FNP-C
• Dannia Hernandez
• Gina Hernandez
• Leandra Hernandez
• Oscar Hernandez, NP

• Mental Health Counselor in San Pedro, CA
• Providers in San Pedro, 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 3, 2022; 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.