MEDICARE: DR. JAMES BAKST M.A.

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	103TA0400X	Addiction (Substance Use Disorder) Psychologist		CA
2	103TF0200X	Forensic Psychologist	36639
3	103T00000X	Psychologist	36639	CA

General Provider Information

NPI Number	:	1588092209
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JAMES BAKST M.A.

Provider Business Mailing Address
First Line	:	1957 PARKSIDE DR STE 200
Second Line	:
City	:	CONCORD
State	:	CA
Zip	:	94519-2525
Country	:	US
Telephone Number	:	925-332-5246
Fax Number	:	925-887-8564

Provider Business Practice Location Address
First Line	:	1957 PARKSIDE DR STE 200
Second Line	:
City	:	CONCORD
State	:	CA
Zip	:	94519-2525
Country	:	US
Telephone Number	:	925-332-5246
Fax Number	:	925-887-8564

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

Provider Enumeration Date	:	10/15/2013
Last Update Date	:	03/23/2026

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