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Individual
ANTHONY THOMAS BAUTISTA
Active
Individual
ANTHONY THOMAS BAUTISTA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
RADT
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
RH0002650519
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
RH0002650519
RADT
CA
Enumeration date
05/20/2020
Last updated
11/27/2023
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