Provider Demographics
NPI:1982025110
Name:BAKUN, DONNA (RAS)
Entity Type:Individual
Prefix:
First Name:DONNA
Middle Name:
Last Name:BAKUN
Suffix:
Gender:F
Credentials:RAS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2975 TREAT BLVD,
Mailing Address - Street 2:B-5
Mailing Address - City:CONCORD
Mailing Address - State:CA
Mailing Address - Zip Code:94518
Mailing Address - Country:US
Mailing Address - Phone:925-691-5083
Mailing Address - Fax:925-691-5369
Practice Address - Street 1:1901 CHURCH LN
Practice Address - Street 2:
Practice Address - City:SAN PABLO
Practice Address - State:CA
Practice Address - Zip Code:94806-3707
Practice Address - Country:US
Practice Address - Phone:510-236-3139
Practice Address - Fax:510-236-3200
Is Sole Proprietor?:Yes
Enumeration Date:2013-12-13
Last Update Date:2013-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)