Provider Demographics
NPI:1336031699
Name:BAUTISTA GUILLEN, NATALIE G
Entity type:Individual
Prefix:
First Name:NATALIE
Middle Name:G
Last Name:BAUTISTA GUILLEN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11506 SUMMER ST
Mailing Address - Street 2:
Mailing Address - City:ADELANTO
Mailing Address - State:CA
Mailing Address - Zip Code:92301-6058
Mailing Address - Country:US
Mailing Address - Phone:323-327-1980
Mailing Address - Fax:
Practice Address - Street 1:11506 SUMMER ST
Practice Address - Street 2:
Practice Address - City:ADELANTO
Practice Address - State:CA
Practice Address - Zip Code:92301-6058
Practice Address - Country:US
Practice Address - Phone:323-327-1980
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-07-19
Last Update Date:2025-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician