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

Randolph Bautista, PTA

Individual provider Physical Therapy Assistant · NPI 1255057303

Randolph Bautista, PTA is a Physical Therapy Assistant in Lakewood, California. Licensed in California. Registered with an NPI since 2022.

Licensed in
CA
In the registry since
2022
What do these letters mean?
PTA — Physical Therapist Assistant
Delivers treatment under a physical therapist's direction.

See every abbreviation used in this directory →

Practice location Address checks out

2108 Lark Bay Ln
Lakewood, CA 90712-2853
Phone: (818) 326-3299
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physical Therapy Assistant (primary) Taxonomy 225200000X · Licence PTA49750 (CA)

Record details

NPI number1255057303
Entity typeIndividual (Type 1)
GenderMale
Credentials PTA
Sole proprietorNo
NPI enumeratedOctober 19, 2022
Last updated in NPPESOctober 19, 2022
Certification dateOctober 19, 2022

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