Provider Demographics
NPI:1598132458
Name:BARNES, ERIK CARL (CCAPP)
Entity Type:Individual
Prefix:MR
First Name:ERIK
Middle Name:CARL
Last Name:BARNES
Suffix:
Gender:M
Credentials:CCAPP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2307 W 6TH ST
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90057-3119
Mailing Address - Country:US
Mailing Address - Phone:213-351-2820
Mailing Address - Fax:
Practice Address - Street 1:2307 W 6TH ST
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90057-3119
Practice Address - Country:US
Practice Address - Phone:213-351-2820
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-08-26
Last Update Date:2015-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAC28081214101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)