Healthcare Provider Details

I. General information

NPI: 1942382973
Provider Name (Legal Business Name): KIM ALISON OLIVA PSY.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/19/2006
Last Update Date: 01/28/2026
Certification Date: 01/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5743 CORSA AVE STE 114
WESTLAKE VILLAGE CA
91362-4072
US

IV. Provider business mailing address

30961 AGOURA RD STE 217
WESTLAKE VILLAGE CA
91361-5619
US

V. Phone/Fax

Practice location:
  • Phone: 818-518-4143
  • Fax:
Mailing address:
  • Phone: 818-518-4143
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License NumberPSY17364
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code103TC2200X
TaxonomyClinical Child & Adolescent Psychologist
License NumberPSY 17364
License Number StateCA
# 3
Primary TaxonomyN
Taxonomy Code103TF0000X
TaxonomyFamily Psychologist
License NumberPSY 17364
License Number StateCA
# 4
Primary TaxonomyN
Taxonomy Code103TM1800X
TaxonomyIntellectual & Developmental Disabilities Psychologist
License NumberPSY 17364
License Number StateCA
# 5
Primary TaxonomyN
Taxonomy Code103TP2701X
TaxonomyGroup Psychotherapy Psychologist
License NumberPSY 17364
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: