Marcelina Bautista

Primary specialty

Adult Care Home FacilityTaxonomy code 311ZA0620X

License

415600504 Issued in CA

Practice address

188 San Felipe Ave
San Bruno, CA 94066-5501

Phone

(650) 952-4398

Fax

(650) 583-6120

NPI assigned

Mar 17, 2011

Last updated

Mar 17, 2011By 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

Other names 1

• Mrs. Marcy Bautista Other name

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": "1300320000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1300320000000",
    "number": "1861791725",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "188 SAN FELIPE AVE",
            "city": "SAN BRUNO",
            "state": "CA",
            "postal_code": "940665501",
            "telephone_number": "650-952-4398",
            "fax_number": "650-583-6120"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "188 SAN FELIPE AVE",
            "city": "SAN BRUNO",
            "state": "CA",
            "postal_code": "940665501",
            "telephone_number": "650-952-4398",
            "fax_number": "650-583-6120"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BAUTISTA",
        "first_name": "MARCELINA",
        "name_prefix": "Mrs.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-03-17",
        "last_updated": "2011-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "311ZA0620X",
            "taxonomy_group": "",
            "desc": "Custodial Care Facility, Adult Care Home",
            "state": "CA",
            "license": "415600504",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MARCY",
            "last_name": "BAUTISTA",
            "prefix": "MRS.",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Katelyn Bass
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• Jade Bautista, PHARMD
• Kyle Anthony Bautista
• Marvin Icban Bautista, D.C.
• Bay Area PL Services
• Bay Area PL Services
• Bayhill Acupuncture Health Center, Inc
• Kristina Marie Becker

• Adult Care Home Facility in San Bruno, CA
• Providers in San Bruno, CA by specialty
• Adult Care Home Facility in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2011; 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.