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:
Credentials:CCAPP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:909 N AVALON BLVD
Mailing Address - Street 2:
Mailing Address - City:WILMINGTON
Mailing Address - State:CA
Mailing Address - Zip Code:90744-4503
Mailing Address - Country:US
Mailing Address - Phone:323-313-6441
Mailing Address - Fax:
Practice Address - Street 1:909 N AVALON BLVD
Practice Address - Street 2:
Practice Address - City:WILMINGTON
Practice Address - State:CA
Practice Address - Zip Code:90744-4503
Practice Address - Country:US
Practice Address - Phone:323-313-6441
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-08-26
Last Update Date:2025-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAC28081214101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)