Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Perla Jazmine Bautista Roman

Individual provider Clinical Social Worker · NPI 1205700531

Perla Jazmine Bautista Roman is a Clinical Social Worker in Phoenix, Arizona. Qualified in 2018, 8 years ago. Licensed in Arizona.

Years since qualifying
8
Licensed in
AZ
In the registry since
2025
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Practice location Address checks out

3864 N 27th Ave
Phoenix, AZ 85017-4703
Phone: (602) 685-6000
Fax: (602) 212-6250
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Clinical Social Worker (primary) Taxonomy 1041C0700X · Licence LCSW-23217 (AZ)

Record details

NPI number1205700531
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorNo
NPI enumeratedSeptember 30, 2025
Last updated in NPPESSeptember 30, 2025
Certification dateSeptember 30, 2025

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyCLINICAL SOCIAL WORKER
Medical schoolOTHER
Graduated 2018 (8 years in practice)
Accepts Medicare assignment Not indicated

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