Healthcare Provider Details

I. General information

NPI: 1639438047
Provider Name (Legal Business Name): ALISON MARIA MAGOUN MORENO PH.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/07/2012
Last Update Date: 08/26/2026
Certification Date: 08/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2660 TOWNSGATE RD STE 450
WESTLAKE VILLAGE CA
91361-5714
US

IV. Provider business mailing address

2660 TOWNSGATE RD STE 450
WESTLAKE VILLAGE CA
91361-5714
US

V. Phone/Fax

Practice location:
  • Phone: 805-300-6719
  • Fax: 805-832-6288
Mailing address:
  • Phone: 805-300-6719
  • Fax: 805-832-6288

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code103T00000X
TaxonomyPsychologist
License NumberPSY24406
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License NumberPSY24406
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: