Eduardo Bautista, RADT

Primary specialty

Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X

License

R1561100524 Issued in CA

Practice address

44359 Palm St
Indio, CA 92201-3116

Phone

(760) 342-6616

NPI assigned

Nov 20, 2018

Last updated

May 5, 2025By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1542672000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1746403200000",
    "number": "1700355633",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "44359 PALM ST",
            "city": "INDIO",
            "state": "CA",
            "postal_code": "922013116",
            "telephone_number": "760-342-6616"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "44359 PALM ST",
            "city": "INDIO",
            "state": "CA",
            "postal_code": "922013116",
            "telephone_number": "760-342-6616"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3605 E Ramon Rd",
            "address_purpose": "LOCATION",
            "city": "Palm Springs",
            "state": "CA",
            "postal_code": "922641150",
            "country_code": "US",
            "telephone_number": "760-325-5630",
            "fax_number": "760-325-5668",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BAUTISTA",
        "first_name": "EDUARDO",
        "credential": "RADT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-11-20",
        "last_updated": "2025-05-05",
        "certification_date": "2025-05-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": "CA",
            "license": "R1561100524",
            "primary": false
        },
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "CA",
            "license": "R1561100524",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Melissa Barron
• Jamie Isabelle Bartlett
• Nevaeh Angelique Bass, AA
• Alejandro Antonio Bautista, M.D.
• Ashley Anahi Bautista
• Juan Bautista, LVN
• Leticia Bautista
• Peter John Bayless-Bonventre, RN
• Liliana Beas Hernandez, AMFT
• Priscilla Beas, ACSW

• Addiction (Substance Use Disorder) Counselor in Indio, CA
• Providers in Indio, CA by specialty
• Addiction (Substance Use Disorder) Counselor in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 5, 2025; 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.