Healthcare Provider Details

I. General information

NPI: 1891974473
Provider Name (Legal Business Name): ALISON CARLTON CAMHI M.A.; LMFT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/30/2007
Last Update Date: 10/30/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

30497 CANWOOD ST SUITE NUMBER 103
AGOURA HILLS CA
91301-4330
US

IV. Provider business mailing address

PO BOX 6283
THOUSAND OAKS CA
91359-6283
US

V. Phone/Fax

Practice location:
  • Phone: 818-917-4346
  • Fax:
Mailing address:
  • Phone: 818-917-4346
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code103TA0400X
TaxonomyAddiction (Substance Use Disorder) Psychologist
License NumberMFC44370
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code103TA0700X
TaxonomyAdult Development & Aging Psychologist
License NumberMFC44370
License Number StateCA
# 3
Primary TaxonomyN
Taxonomy Code103TB0200X
TaxonomyCognitive & Behavioral Psychologist
License NumberMFC44370
License Number StateCA
# 4
Primary TaxonomyN
Taxonomy Code103TC2200X
TaxonomyClinical Child & Adolescent Psychologist
License NumberMFC44370
License Number StateCA
# 5
Primary TaxonomyN
Taxonomy Code103TF0000X
TaxonomyFamily Psychologist
License NumberMFC44370
License Number StateCA
# 6
Primary TaxonomyN
Taxonomy Code103TP2701X
TaxonomyGroup Psychotherapy Psychologist
License NumberMFC44370
License Number StateCA
# 7
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License NumberMFC44370
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: