MEDICARE: ALISON L DUNCAN PSYD., BCBA

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	103TC2200X	Clinical Child & Adolescent Psychologist	PSY28009	CA
2	103K00000X	Behavior Analyst	1118786	CA

General Provider Information

NPI Number	:	1992049639
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ALISON L DUNCAN PSYD., BCBA

Provider Business Mailing Address
First Line	:	12062 VALLEY VIEW ST STE 220
Second Line	:
City	:	GARDEN GROVE
State	:	CA
Zip	:	92845-1739
Country	:	US
Telephone Number	:	203-494-1328
Fax Number	:

Provider Business Practice Location Address
First Line	:	12062 VALLEY VIEW ST STE 220
Second Line	:
City	:	GARDEN GROVE
State	:	CA
Zip	:	92845-1739
Country	:	US
Telephone Number	:	203-494-1328
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/19/2012
Last Update Date	:	01/10/2020

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