Active NPI
Paola Andrea Bautista, M.A., MFT
- Marriage & Family Therapist
- Orange, CA
National Provider Identifier
1962515759
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Marriage & Family Therapist
- Practice address
- 301 The City Dr S
Orange, CA 92868 - Phone
- (714) 935-8200
- Fax
- (714) 935-8112
- NPI assigned
- Aug 16, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Marriage & Family Therapist | 106H00000X | Primary |
Addresses
Primary practice location
301 The City Dr S
Orange, CA 92868
Mailing address
PO Box 7244
Mob # 44
Orange, CA 92863-7244
Phone (714) 935-8200
Other practice location 1
6200 E Canyon Rim Rd
Suite 212E
Anaheim, CA 92807-4317
Phone (714) 721-0860
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Master of Arts
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1155686400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1568332800000",
"number": "1962515759",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 7244",
"address_2": "MOB # 44",
"city": "ORANGE",
"state": "CA",
"postal_code": "928637244",
"telephone_number": "714-935-8200"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "301 THE CITY DR S",
"city": "ORANGE",
"state": "CA",
"postal_code": "92868",
"telephone_number": "714-935-8200",
"fax_number": "714-935-8112"
}
],
"practiceLocations": [
{
"address_1": "6200 E Canyon Rim Rd",
"address_2": "Suite 212E",
"address_purpose": "LOCATION",
"city": "Anaheim",
"state": "CA",
"postal_code": "928074317",
"country_code": "US",
"telephone_number": "714-721-0860",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "BAUTISTA",
"first_name": "PAOLA",
"middle_name": "ANDREA",
"credential": "M.A., MFT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-08-16",
"last_updated": "2019-09-13",
"status": "A"
},
"taxonomies": [
{
"code": "106H00000X",
"taxonomy_group": "",
"desc": "Marriage & Family Therapist",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Orange, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 13, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.