MEDICARE: JONATHAN H BACH LMFT

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	106H00000X	Marriage & Family Therapist	MFC50320	CA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	956003956	OTHER	CA	MEDI-CAL

General Provider Information

NPI Number	:	1295853570
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JONATHAN H BACH LMFT

Provider Business Mailing Address
First Line	:	9038 ORION AVE UNIT 106
Second Line	:
City	:	NORTH HILLS
State	:	CA
Zip	:	91343-4273
Country	:	US
Telephone Number	:	818-725-6793
Fax Number	:

Provider Business Practice Location Address
First Line	:	9038 ORION AVE UNIT 106
Second Line	:
City	:	NORTH HILLS
State	:	CA
Zip	:	91343-4273
Country	:	US
Telephone Number	:	818-725-6793
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/26/2007
Last Update Date	:	03/04/2026

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