Provider Demographics
NPI:1700281144
Name:BAKOZ, NINWAY
Entity Type:Individual
Prefix:
First Name:NINWAY
Middle Name:
Last Name:BAKOZ
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2524 FINNEY RD
Mailing Address - Street 2:
Mailing Address - City:MODESTO
Mailing Address - State:CA
Mailing Address - Zip Code:95358-9765
Mailing Address - Country:US
Mailing Address - Phone:209-550-5858
Mailing Address - Fax:
Practice Address - Street 1:2524 FINNEY RD
Practice Address - Street 2:
Practice Address - City:MODESTO
Practice Address - State:CA
Practice Address - Zip Code:95358-9765
Practice Address - Country:US
Practice Address - Phone:209-550-5858
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-10-28
Last Update Date:2018-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator
No101Y00000XBehavioral Health & Social Service ProvidersCounselor