Provider Demographics
NPI:1144484338
Name:ALON, FAY T (PHD)
Entity type:Individual
Prefix:DR
First Name:FAY
Middle Name:T
Last Name:ALON
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:21241 VENTURA BLVD
Mailing Address - Street 2:SUITE #267
Mailing Address - City:WOODLAND HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:91364-2108
Mailing Address - Country:US
Mailing Address - Phone:818-754-4336
Mailing Address - Fax:
Practice Address - Street 1:21241 VENTURA BLVD
Practice Address - Street 2:SUITE #267
Practice Address - City:WOODLAND HILLS
Practice Address - State:CA
Practice Address - Zip Code:91364-2108
Practice Address - Country:US
Practice Address - Phone:818-754-4336
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-07-16
Last Update Date:2008-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY15481103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist