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General NPI Number Information
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NPI Number | 1669881082
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Entity Type | Individual
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Provider Name | ALYSON GOULD
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Gender | Female
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Dates
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Enumeration Date | 08/11/2014
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Last Update Date | 11/21/2018
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Provider Practice Location Address
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Address Line | 1010 N CENTRAL AVE STE 310
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City | GLENDALE
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State | CA
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Zip | 91202-2937
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Country | US
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Telephone | 818-724-9770
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Fax | 818-484-2991
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Provider Business Mailing Address
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Address Line | 239 E MONTANA ST
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City | PASADENA
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State | CA
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Zip | 91104-1059
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Country | US
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Telephone | 818-421-8277
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225400000X
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Taxonomy Name | Rehabilitation Practitioner
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | 105158
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License Number State | CA
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