Healthcare Provider Details
I. General information
NPI: 1740614718
Provider Name (Legal Business Name): ALONIE ELIZABETH BUTLER PSYD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y
II. Dates (important events)
Enumeration Date: 08/27/2013
Last Update Date: 02/13/2025
Certification Date: 02/13/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1560 E CHEVY CHASE DR STE 130
GLENDALE CA
91206-4140
US
IV. Provider business mailing address
1560 E CHEVY CHASE DR STE 130
GLENDALE CA
91206-4140
US
V. Phone/Fax
- Phone: 818-240-0340
- Fax:
- Phone:
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 103T00000X |
| Taxonomy | Psychologist |
| License Number | 31133 |
| License Number State | CA |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 103TC0700X |
| Taxonomy | Clinical Psychologist |
| License Number | 31133 |
| License Number State | CA |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: