Basic Information
| Provider Information | |||||||||
| NPI: | 1164029005 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | BARNHARDT | ||||||||
| FirstName: | ADAM | ||||||||
| MiddleName: | LYLE | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1030NORTH VIRGIL AVE. | ||||||||
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| City: | L.A. | ||||||||
| State: | CA | ||||||||
| PostalCode: | 90029 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3104936126 | ||||||||
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| Practice Location | |||||||||
| Address1: | 11500 PARAMONT BLVD. | ||||||||
| Address2: | |||||||||
| City: | DOWNEY | ||||||||
| State: | CA | ||||||||
| PostalCode: | 90241 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5629234545 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 10/05/2020 | ||||||||
| LastUpdateDate: | 10/05/2020 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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| NPICertificationDate: | 09/29/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 101YA0400X | Y | Behavioral Health & Social Service Providers | Counselor | Addiction (Substance Use Disorder) |
No ID Information.