Healthcare Provider Details

I. General information

NPI: 1245982883
Provider Name (Legal Business Name): CONEJO HEALTH
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/25/2022
Last Update Date: 11/02/2025
Certification Date: 11/02/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

31111 AGOURA RD
WESTLAKE VILLAGE CA
91361-4449
US

IV. Provider business mailing address

PO BOX 7741
WESTLAKE VILLAGE CA
91359-7741
US

V. Phone/Fax

Practice location:
  • Phone: 818-390-9444
  • Fax: 818-381-0007
Mailing address:
  • Phone: 818-390-9444
  • Fax: 818-381-0007

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code251K00000X
TaxonomyPublic Health or Welfare Agency
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code261QR0405X
TaxonomySubstance Use Disorder Rehabilitation Clinic/Center
License Number
License Number State
# 5
Primary TaxonomyN
Taxonomy Code333600000X
TaxonomyPharmacy
License Number
License Number State

VIII. Authorized Official

Name: MR. MATTHEW PALL
Title or Position: CEO
Credential: NRP, CP-C
Phone: 818-390-9444