Healthcare Provider Details

I. General information

NPI: 1538955604
Provider Name (Legal Business Name): SARA ROJAS BAUTISTA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/16/2025
Last Update Date: 08/22/2025
Certification Date: 08/22/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

514 N KAWEAH AVE
EXETER CA
93221-1200
US

IV. Provider business mailing address

615 S ATWOOD ST
VISALIA CA
93277-8302
US

V. Phone/Fax

Practice location:
  • Phone: 559-594-4969
  • Fax:
Mailing address:
  • Phone: 559-732-8056
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code174H00000X
TaxonomyHealth Educator
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: