Provider Demographics
NPI:1568883916
Name:BAUTISTA, ATLAS STEVE (BA PSYCHOLOGY)
Entity Type:Individual
Prefix:
First Name:ATLAS
Middle Name:STEVE
Last Name:BAUTISTA
Suffix:
Gender:M
Credentials:BA PSYCHOLOGY
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Mailing Address - Street 1:3680 N RANCHO DR
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89130-3180
Mailing Address - Country:US
Mailing Address - Phone:702-869-4300
Mailing Address - Fax:702-869-4301
Practice Address - Street 1:3680 N RANCHO DR
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89130-3180
Practice Address - Country:US
Practice Address - Phone:702-869-4300
Practice Address - Fax:702-869-4301
Is Sole Proprietor?:No
Enumeration Date:2014-01-01
Last Update Date:2014-01-01
Deactivation Date:
Deactivation Code:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst