Bautista, Divina Gracia P.
Bautista, Divina Gracia P. is an individual health care provider with primary practice located at 1239 Aden Road , Pasadena CA 91125. She recently has 3 registered licenses in different health care specialties including Physician Assistants & Advanced Practice Nursing Providers / Family, Physician Assistants & Advanced Practice Nursing Providers / School, Physician Assistants & Advanced Practice Nursing Providers / Primary Care. Physician Assistants & Advanced Practice Nursing Providers / Primary Care is her primary health care specialty. Bautista, Divina Gracia P. can be contacted via phone (626) 395-6393.Contact Information
Primary practice address
1239 Aden Road
Pasadena CA 91125
Phone: (626) 395-6393
Fax: (626) 585-1522
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Physician Assistants & Advanced Practice Nursing Providers / Family | 363LF0000X | NP7363 | California |
| Physician Assistants & Advanced Practice Nursing Providers / School | 363LS0200X | NP7363 | California |
| Physician Assistants & Advanced Practice Nursing Providers / Primary Care | 363LP2300X | NP7363 | California |
Profile Details
| NPI number | 1952810772 |
|---|---|
| LBN Legal business name | Bautista, Divina Gracia P. |
| Credentials | Nurse Practitioner (NP) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Sep 25th, 2017 |
| Last updated | Oct 2nd, 2017 - about 9 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
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