JENNIFER LORRAINE BAUTISTA — OIG Excluded Provider (GRASS VALLEY, CA, 1128b4)
JENNIFER LORRAINE BAUTISTA — OIG Excluded Provider (GRASS VALLEY, CA, 1128b4) is one of 9,000 exclusions in the ExcludeCheck dataset. Key details — Name: JENNIFER LORRAINE BAUTISTA; Type: Individual; Provider category: IND- LIC HC SERV PRO.
| Name | JENNIFER LORRAINE BAUTISTA |
|---|---|
| Type | Individual |
| Provider category | IND- LIC HC SERV PRO |
| Specialty | NURSE/NURSES AIDE |
| City | GRASS VALLEY |
| State | CA |
| ZIP | 95945 |
| Exclusion authority | 1128b4 |
| Exclusion reason | License revocation, suspension, or surrender |
| Exclusion date | 2020-09-20 |
| Source | HHS-OIG LEIE |
$1499/mo
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