Kristine Joyce Geronimo Bautista, OTR/L

Primary specialty

Occupational TherapistTaxonomy code 225X00000X

License

11556 Issued in CA

Practice address

111 Elm St
San Diego, CA 92101-2692

Phone

(619) 677-3800

NPI assigned

Sep 28, 2017

Last updated

Mar 17, 2018By the provider in NPPES

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

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Robert Marriott Medical Corp

  dba Advantage Wound Care

  • Surgery Physician
  • El Segundo, CA
  • NPI 1083883938

  Single Specialty

  NPD (past)

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

{
    "created_epoch": "1506556800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521244800000",
    "number": "1699284034",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "602 NANTUCKET DR",
            "city": "CHULA VISTA",
            "state": "CA",
            "postal_code": "919116817",
            "telephone_number": "619-616-9133"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "111 ELM ST",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921012692",
            "telephone_number": "619-677-3800"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "630 L St",
            "address_purpose": "LOCATION",
            "city": "Chula Vista",
            "state": "CA",
            "postal_code": "919111066",
            "country_code": "US",
            "telephone_number": "619-271-7100",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BAUTISTA",
        "first_name": "KRISTINE JOYCE",
        "middle_name": "GERONIMO",
        "credential": "OTR/L",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-09-28",
        "last_updated": "2018-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Occupational Therapist",
            "state": "CA",
            "license": "11556",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jenia Bautista, RN
• Jennifer Del Pilar Bautista, MD
• Jennigrace Bautista, PHARM. D.
• Josefina Odulio Bautista, MEDICAL ASSISTANT
• Justin Bautista
• Leanna Mae Florentino Bautista
• Lino O. Bautista, MD
• Maria Corazon Bautista, M.D.
• Marie Angela M Bautista, MS, PA-C
• Oscar Russell Ordonez Bautista, P.T.

• Occupational Therapist in San Diego, CA
• Providers in San Diego, CA by specialty
• Occupational Therapist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2018; 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.