Healthcare Provider Details

I. General information

NPI: 1316731490
Provider Name (Legal Business Name): AKO EYONG
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/05/2025
Last Update Date: 04/05/2025
Certification Date: 04/05/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

30125 AGOURA ROAD SUITE F
AGOURA HILLS CA
91301
US

IV. Provider business mailing address

28947 THOUSAND OAKS BLVD UNIT 134
AGOURA HILLS CA
91301-2139
US

V. Phone/Fax

Practice location:
  • Phone: 805-258-8168
  • Fax:
Mailing address:
  • Phone: 805-258-8168
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: