Individual
AMANDA BAUTISTA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1710 S AMPHLETT BLVD STE 314, SAN MATEO, CA 94402-2736
(650) 242-0179
Mailing address
1710 S AMPHLETT BLVD STE 314, SAN MATEO, CA 94402-2736
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Enumeration date
12/15/2015
Last updated
12/15/2015
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