Provider Demographics
NPI:1194030148
Name:MONCADA, ALLYSON BROOKE (LMFT)
Entity Type:Individual
Prefix:MRS
First Name:ALLYSON
Middle Name:BROOKE
Last Name:MONCADA
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:ALLYSON
Other - Middle Name:BROOKE
Other - Last Name:BUICE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:9400 CORBIN AVE APT 1012
Mailing Address - Street 2:
Mailing Address - City:NORTHRIDGE
Mailing Address - State:CA
Mailing Address - Zip Code:91324-2524
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1227 E LOS ANGELES AVE
Practice Address - Street 2:
Practice Address - City:SIMI VALLEY
Practice Address - State:CA
Practice Address - Zip Code:93065-2871
Practice Address - Country:US
Practice Address - Phone:805-582-4080
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-08-14
Last Update Date:2020-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAIMF 68099106H00000X
CA91044106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist