Provider Demographics
NPI:1932765773
Name:BAHRA AND ASSOCIATES
Entity Type:Organization
Organization Name:BAHRA AND ASSOCIATES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LCSW/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ERIC
Authorized Official - Middle Name:
Authorized Official - Last Name:BAHRA
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:714-290-3009
Mailing Address - Street 1:14390 PARK AVE
Mailing Address - Street 2:
Mailing Address - City:VICTORVILLE
Mailing Address - State:CA
Mailing Address - Zip Code:92392-2310
Mailing Address - Country:US
Mailing Address - Phone:714-305-3500
Mailing Address - Fax:714-276-9436
Practice Address - Street 1:15497 W SAND ST
Practice Address - Street 2:
Practice Address - City:VICTORVILLE
Practice Address - State:CA
Practice Address - Zip Code:92392-2910
Practice Address - Country:US
Practice Address - Phone:442-327-9311
Practice Address - Fax:442-327-9315
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-05-17
Last Update Date:2020-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty
No103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Single Specialty
No103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounselingGroup - Single Specialty
No103TF0200XBehavioral Health & Social Service ProvidersPsychologistForensicGroup - Single Specialty