Provider Demographics
NPI:1982025110
Name:BAKUN, DONNA (CCAPP)
Entity type:Individual
Prefix:
First Name:DONNA
Middle Name:
Last Name:BAKUN
Suffix:
Gender:F
Credentials:CCAPP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4645 PACHECO BLVD
Mailing Address - Street 2:
Mailing Address - City:MARTINEZ
Mailing Address - State:CA
Mailing Address - Zip Code:94553-3625
Mailing Address - Country:US
Mailing Address - Phone:925-646-9270
Mailing Address - Fax:256-469-2769
Practice Address - Street 1:4645 PACHECO BLVD
Practice Address - Street 2:
Practice Address - City:MARTINEZ
Practice Address - State:CA
Practice Address - Zip Code:94553-3625
Practice Address - Country:US
Practice Address - Phone:925-646-9270
Practice Address - Fax:925-646-9276
Is Sole Proprietor?:Yes
Enumeration Date:2013-12-13
Last Update Date:2024-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No172V00000XOther Service ProvidersCommunity Health Worker