Provider Demographics
NPI:1457574501
Name:BARKER, SIMON JOHN (ND)
Entity Type:Individual
Prefix:DR
First Name:SIMON
Middle Name:JOHN
Last Name:BARKER
Suffix:
Gender:M
Credentials:ND
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:740 N LAKE AVE
Mailing Address - Street 2:
Mailing Address - City:PASADENA
Mailing Address - State:CA
Mailing Address - Zip Code:91104-4557
Mailing Address - Country:US
Mailing Address - Phone:626-794-4668
Mailing Address - Fax:626-345-9753
Practice Address - Street 1:740 N LAKE AVE
Practice Address - Street 2:
Practice Address - City:PASADENA
Practice Address - State:CA
Practice Address - Zip Code:91104-4557
Practice Address - Country:US
Practice Address - Phone:626-794-4668
Practice Address - Fax:626-345-9753
Is Sole Proprietor?:No
Enumeration Date:2007-04-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAND128175F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175F00000XOther Service ProvidersNaturopath