John Bacon, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

LCSW15457 Issued in CA

Practice address

4301 De Ette Ave
Bakersfield, CA 93313-2916

Phone

(661) 619-7047

Fax

(661) 396-2349

NPI assigned

Nov 25, 2020

Last updated

Nov 25, 2020By the provider in NPPES

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Kern Bridges Youth Homes, Inc.

  dba John and Dorthy Almklov House

  • Emotionally Disturbed Childrens' Residential Treatment Facility
  • Bakersfield, CA
  • NPI 1922601897
  NPD
• Kern Bridges Youth Homes, Inc.

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Bakersfield, CA
  • NPI 1154143824

  Clinical

  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1606262400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1606262400000",
    "number": "1619571072",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1321 STINE RD",
            "city": "BAKERSFIELD",
            "state": "CA",
            "postal_code": "933094176",
            "telephone_number": "661-396-2362",
            "fax_number": "661-396-2349"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4301 DE ETTE AVE",
            "city": "BAKERSFIELD",
            "state": "CA",
            "postal_code": "933132916",
            "telephone_number": "661-619-7047",
            "fax_number": "661-396-2349"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BACON",
        "first_name": "JOHN",
        "name_prefix": "Mr.",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-11-25",
        "last_updated": "2020-11-25",
        "certification_date": "2020-11-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "LCSW15457",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Robert T Baca Jr.
• Hegina Grace Medrozo Bacallo
• Charissa Gajete Bacena-Miano, MSN, NP-C
• Back 2 Life Chiropractic Corp. David L. Halpain, D.C.
• Jeffrey Kyle Bacon, D.O.
• Nancy M.K. Bacon, LMFT
• David Bacus, FNP
• Hannah Abigail Garcia Bacuyag
• Gabrielle Badasci
• Pritam S Badesha, MD

• Clinical Social Worker in Bakersfield, CA
• Providers in Bakersfield, CA by specialty
• Clinical Social Worker in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 25, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.