Provider Demographics
NPI:1316195860
Name:ZBACNIK, JL (LMFT)
Entity type:Individual
Prefix:
First Name:JL
Middle Name:
Last Name:ZBACNIK
Suffix:
Gender:M
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:982 MISSION ST
Mailing Address - Street 2:2ND FLOOR
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94103-2911
Mailing Address - Country:US
Mailing Address - Phone:415-597-8059
Mailing Address - Fax:415-597-8004
Practice Address - Street 1:982 MISSION ST
Practice Address - Street 2:2ND FLOOR
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94103-2911
Practice Address - Country:US
Practice Address - Phone:415-597-8059
Practice Address - Fax:415-597-8004
Is Sole Proprietor?:Yes
Enumeration Date:2008-09-08
Last Update Date:2015-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101YM0800X
CA62060106H00000X
CA79584106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health