Provider Demographics
NPI:1386346047
Name:ABDULLAH, JONATHAN BILAL (EDD, LMFT)
Entity type:Individual
Prefix:DR
First Name:JONATHAN
Middle Name:BILAL
Last Name:ABDULLAH
Suffix:
Gender:M
Credentials:EDD, LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1961 N C ST
Mailing Address - Street 2:
Mailing Address - City:OXNARD
Mailing Address - State:CA
Mailing Address - Zip Code:93036-2990
Mailing Address - Country:US
Mailing Address - Phone:805-272-0077
Mailing Address - Fax:747-222-7107
Practice Address - Street 1:30941 AGOURA RD STE 210
Practice Address - Street 2:
Practice Address - City:WESTLAKE VILLAGE
Practice Address - State:CA
Practice Address - Zip Code:91361-4658
Practice Address - Country:US
Practice Address - Phone:805-272-0077
Practice Address - Fax:747-222-7107
Is Sole Proprietor?:Yes
Enumeration Date:2023-03-20
Last Update Date:2024-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA148120101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health