Healthcare Provider Details

I. General information

NPI: 1376180141
Provider Name (Legal Business Name): JONATHAN PAUL MICHAEL BARBER LAADC/ICAADC, ASW
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/29/2019
Last Update Date: 04/15/2026
Certification Date: 04/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6909 FALLBROOK AVE
WEST HILLS CA
91307-2513
US

IV. Provider business mailing address

23055 SHERMAN WAY PO BOX 4233
WEST HILLS CA
91307-2000
US

V. Phone/Fax

Practice location:
  • Phone: 747-230-4123
  • Fax: 747-230-4125
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code104100000X
TaxonomySocial Worker
License NumberASW131176
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License NumberLR03190426
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: