Provider Demographics
NPI:1851738413
Name:BAUTISTA, HAPPY HERRERA
Entity Type:Individual
Prefix:
First Name:HAPPY
Middle Name:HERRERA
Last Name:BAUTISTA
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 1:1613 S MAIN ST
Mailing Address - Street 2:SUITE 103
Mailing Address - City:MILPITAS
Mailing Address - State:CA
Mailing Address - Zip Code:95035-6295
Mailing Address - Country:US
Mailing Address - Phone:209-890-9941
Mailing Address - Fax:
Practice Address - Street 1:1613 S MAIN ST
Practice Address - Street 2:SUITE 103
Practice Address - City:MILPITAS
Practice Address - State:CA
Practice Address - Zip Code:95035-6295
Practice Address - Country:US
Practice Address - Phone:209-890-9941
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-05-22
Last Update Date:2013-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health