Individual provider Active NPI

Johnathan West Barker, MSW, ASCW

  • Social Worker
  • Lake Elsinore, CA
National Provider Identifier
1750533915
Registry record updated Jun 14, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
License
ASW71218 Issued in CA
Practice address
31764 Casino Dr
Ste 300
Lake Elsinore, CA 92530-4571
Phone
(951) 471-4645
Fax
(951) 471-4687
NPI assigned
Oct 21, 2008
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 14, 2016

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X
Social Worker 104100000X ASW71218 CA Primary

Addresses

Primary practice location

31764 Casino Dr
Ste 300
Lake Elsinore, CA 92530-4571

Mailing address

31764 Casino Dr
Ste 300
Lake Elsinore, CA 92530-4571
Phone (951) 471-4645

Other identifiers 1

IdentifierTypeStateIssuer
7068MedicaidCA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
ASW71218CAMDSocial Worker

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1224547200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1465862400000",
    "number": "1750533915",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "31764 CASINO DR",
            "address_2": "STE 300",
            "city": "LAKE ELSINORE",
            "state": "CA",
            "postal_code": "925304571",
            "telephone_number": "951-471-4645",
            "fax_number": "951-471-4687"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "31764 CASINO DR",
            "address_2": "STE 300",
            "city": "LAKE ELSINORE",
            "state": "CA",
            "postal_code": "925304571",
            "telephone_number": "951-471-4645",
            "fax_number": "951-471-4687"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BARKER",
        "first_name": "JOHNATHAN",
        "middle_name": "WEST",
        "credential": "MSW, ASCW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-10-21",
        "last_updated": "2016-06-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "CA",
            "license": "ASW71218",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7068",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lake Elsinore, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 14, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.