Individual provider · Type 1 NPI
Divina Gracia P. Bautista, N.P.
Primary Care Nurse Practitioner · Pasadena, CA
NPI number
1952810772
Active
Practice location
1239 Aden Road
Pasadena, CA 91125
Fax (626) 585-1522
Mailing address
1239 Arden Road
Pasadena, CA 91125
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Family Nurse Practitioner | 363LF0000X | NP7363 (CA) |
| School Nurse Practitioner | 363LS0200X | NP7363 (CA) |
| Primary Care Nurse Practitioner Primary | 363LP2300X | NP7363 (CA) |
Primary Care Nurse Practitioner: Definition to come...
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About NPI 1952810772
Divina Gracia P. Bautista, N.P.'s National Provider Identifier is 1952810772, issued on Sep 25, 2017. The primary taxonomy on file is Primary Care Nurse Practitioner (363LP2300X), and the practice location is in Pasadena, CA. The record was last updated on Oct 2, 2017.