JAMES BENJAMIN BACON (NPI# 1811496672) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1811496672 |
| Entity Type | Individual |
| Full Name | JAMES BENJAMIN BACON |
| Practice Address |
18646 Oxnard St Tarzana CA 91356-1411 |
| Mailing Address |
10982 Topeka Dr Northridge CA 91326-2322 |
| Practice Telephone | 8189961051 |
| Mailing Telephone | 8182612456 |
| Enumeration Date | 2018-02-07 |
| Last Update Date | 2018-02-07 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QR0401X |
Clinic/Center Specialization: Rehabilitation, Comprehensive Outpatient Rehabilitation Facility (CORF) |
Ambulatory Health Care Facilities |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1972953263 | James Wesley Bacon | Occupational Therapist | 1770 S Rock Rd Apt 810, Wichita, KS 67207-5177 | 2016-06-16 |
| 1790173573 | James Bacon | General Acute Care Hospital | 507 S Main St, Viroqua, WI 54665-2059 | 2015-01-02 |
| 1295055796 | James David Bacon | Anesthesiology | University of Kentucky, 800 Rose Street, Lexington, KY 40536-0293 | 2010-06-07 |
| 1982684619 | James Bacon | Emergency Medicine | 1325 Broadway St, Rockport, TX 78382-3333 | 2006-01-19 |
| 1063413474 | James P. Bacon | Internal Medicine | 335 Glessner Ave, Mansfield, OH 44903-2269 | 2005-08-09 |
| Street Address |
18646 OXNARD ST |
| City | TARZANA |
| State | CA |
| Zip Code | 91356-1411 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1841202066 | Desiree Ginette Gonzalez Long | Marriage & Family Therapist | 18646 Oxnard St, Tarzana, CA 91356-1411 | 2006-08-13 |
| 1407456155 | Amber Ruiz | Counselor | 18646 Oxnard St, Tarzana, CA 91356-1411 | 2020-10-30 |
| 1265032932 | Jason R Oster | Counselor | 18646 Oxnard St, Tarzana, CA 91356-1486 | 2020-10-30 |
| 1194322487 | Briana Johnson | Case Manager/Care Coordinator | 18646 Oxnard St, Tarzana, CA 91356-1411 | 2020-10-08 |
| 1487261780 | Alison Benson | Counselor | 18646 Oxnard St, Tarzana, CA 91356-1411 | 2020-09-30 |
| 1558978056 | Erica Hernandez | Case Manager/Care Coordinator | 18646 Oxnard St, Tarzana, CA 91356-1486 | 2020-09-28 |
| 1073124905 | Guy Martin Sherk | Counselor | 18646 Oxnard St, Tarzana, CA 91356-1411 | 2020-08-13 |
| 1538770615 | Breek Sundy | Licensed Vocational Nurse | 18646 Oxnard St, Tarzana, CA 91356-1411 | 2020-08-12 |
| 1336759364 | David Lundberg | Counselor | 18646 Oxnard St, Tarzana, CA 91356-1486 | 2020-08-04 |
| 1740890193 | Teresa Lynn Herrera | Counselor | 18646 Oxnard St, Tarzana, CA 91356-1411 | 2020-07-31 |
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|---|---|---|---|---|
| 1679137293 | Sarah Badreau | Behavior Technician | 5554 Reseda Blv., Tarzana, CA 91356 | 2019-04-29 |
| 1831661966 | Daraie Dental Group Inc | Dentist | 5620 Wilbur Avenue Ste 300, Tarzana, CA 91356 | 2018-12-31 |
| 1982182770 | Blanca Garay | Respiratory Therapist, Registered | 18214 Burbank Blvd Apt 120, Tarzana, CA 91356 | 2018-08-02 |
| 1437659000 | Chloe Kang | Speech-Language Pathologist | 19019 Ventura Blvd., Tarzana, CA 91356 | 2018-02-20 |
| 1114430139 | Avb & Lv Corporation | Home Health | 18340 Ventura Blvd Ste 220, Tarzana, CA 91356 | 2017-11-13 |
| 1881110468 | Samina Qadir | Registered Nurse | 18321 Clark St., Tarzana, CA 91356 | 2017-08-16 |
| 1700306776 | Debbie Rehman Lux | Marriage & Family Therapist | 18370 Burbank Blvd., Suite 211, Tarzana, CA 91356 | 2017-06-21 |
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| 1669906020 | Evolve Growth Initiatives LLC | Clinic/Center | 5435 Aura Avenue, Tarzana, CA 91356 | 2017-04-12 |
| 1780130088 | Evolve Growth Initiatives, LLC | Clinic/Center | 5358 Vanalden Drive, Tarzana, CA 91356 | 2016-08-28 |
| Find all providers in zip 91356 | ||||
| Taxonomy Code | 261QR0401X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Rehabilitation, Comprehensive Outpatient Rehabilitation Facility (CORF) |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1790706695 | Valley Corf, Inc. | Clinic/Center | 5620 Wilbur Ave, Suite 103, Tarzana, CA 91356-1351 | 2006-07-23 |
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| 1770052748 | The Kibbutz - Nature Serenity Renewal | Clinic/Center | 13136 Elizabeth Lake Rd, Leona Valley, CA 93551 | 2018-11-19 |
| 1144795261 | Divine Bliss, Inc. | Clinic/Center | 1219 Parnell Pl, Costa Mesa, CA 92626-2737 | 2018-10-04 |
| 1407346489 | True North Detox LLC | Clinic/Center | 2121 Herndon Ave Ste 102, Clovis, CA 93611-6302 | 2018-05-15 |
| 1851898811 | Sober First Recovery LLC | Clinic/Center | 3309 Clay St, Newport Beach, CA 92663-4208 | 2018-04-06 |
| 1306354634 | Sea Change Santa Monica, Lp | Clinic/Center | 1051 Princeton St, Santa Monica, CA 90403 | 2018-01-22 |
| 1356860738 | Destiny Recovery Center Iop | Clinic/Center | 23041 Avenida De La Carlota Ste 280, Laguna Hills, CA 92653-1531 | 2017-09-17 |
| 1073966370 | New U Beginnings Inc | Clinic/Center | 5205 Agnes Ave, Valley Village, CA 91607-2701 | 2016-07-21 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.