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NPI Code Detail

MEDICARE: MS. DENNYS BAUTISTA

MEDICARE: MS. DENNYS BAUTISTA
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
13747P1801XPersonal Care Attendant
2103K00000XBehavior Analyst

General Provider Information

NPI Number : 1104260546
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. DENNYS BAUTISTA
Provider Business Mailing Address
First Line : 4550 W OAKEY BLVD STE 104A
Second Line :
City : LAS VEGAS
State : NV
Zip : 89102-1506
Country : US
Telephone Number : 702-427-5307
Fax Number :
Provider Business Practice Location Address
First Line : 4550 W OAKEY BLVD STE 104A
Second Line :
City : LAS VEGAS
State : NV
Zip : 89102-1506
Country : US
Telephone Number : 702-427-5307
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/27/2013
Last Update Date : 02/06/2019

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Directions to “ MS. DENNYS BAUTISTA ” Practice Location

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