Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103G00000X | Clinical Psychologist | 31790 | CA |
Y | 103TC0700X | Clinical Psychologist | 31790 | CA |
NPI | 1003430430 |
---|---|
Provider Name | Allison Brown |
First Address | Encino, CA 91416-7281 |
Second Address | Lake Balboa, CA 91406-5402 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 01/06/2020 |
Last Update Date | 01/06/2020 |