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General NPI Number Information
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NPI Number | 1528159365
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Entity Type | Individual
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Provider Name | NANCY M.K. BACON LMFT
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Gender | Female
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Dates
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Enumeration Date | 09/27/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 2212 F ST
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City | BAKERSFIELD
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State | CA
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Zip | 93301-3828
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Country | US
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Telephone | 661-322-7111
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Fax | 661-325-2031
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Provider Business Mailing Address
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Address Line | 8712 DUNCANSON DR
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City | BAKERSFIELD
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State | CA
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Zip | 93311-1912
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Country | US
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Telephone | 661-665-1699
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | LMFT 34567
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License Number State | CA
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