Amanda Bautista

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

Practice address

1710 S Amphlett Blvd Ste 314
San Mateo, CA 94402-2736

Phone

(650) 242-0179

NPI assigned

Dec 15, 2015

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

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Opted out of Medicare

Yes, effective Mar 6, 2024 through Mar 6, 2028

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 and National Provider Directory roles.

• Pacific Autism Learning Services, Inc

  • Community/Behavioral Health Agency
  • San Mateo, CA
  • NPI 1336435734
  NPD (past)

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

{
    "created_epoch": "1450137600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1450137600000",
    "number": "1841655040",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1710 S AMPHLETT BLVD STE 314",
            "city": "SAN MATEO",
            "state": "CA",
            "postal_code": "944022736"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1710 S AMPHLETT BLVD STE 314",
            "city": "SAN MATEO",
            "state": "CA",
            "postal_code": "944022736",
            "telephone_number": "650-242-0179"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BAUTISTA",
        "first_name": "AMANDA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-12-15",
        "last_updated": "2015-12-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Yulien Batista
• Cherokee Batten
• Margaret Irene Baum
• Kimberly Bausback
• Joselyn Natividad Bautista Zamudio, MSW
• Bay Area Pediatric Medical Group Inc
• Bay Area Reproductive Healthcare PC
• Bay Area Sports Clinic
• Bay Area Urology Medical Group
• Bay Area Urology Medical Group

• Mental Health Counselor in San Mateo, CA
• Providers in San Mateo, 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 Dec 15, 2015; 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; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.