Provider Demographics
NPI:1699180414
Name:OWEN, ALYONKA (LMFT)
Entity Type:Individual
Prefix:
First Name:ALYONKA
Middle Name:
Last Name:OWEN
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2275 S MAIN ST
Mailing Address - Street 2:SUITE 201
Mailing Address - City:CORONA
Mailing Address - State:CA
Mailing Address - Zip Code:92882-5303
Mailing Address - Country:US
Mailing Address - Phone:951-279-1333
Mailing Address - Fax:951-279-5222
Practice Address - Street 1:2275 S MAIN ST
Practice Address - Street 2:SUITE 201
Practice Address - City:CORONA
Practice Address - State:CA
Practice Address - Zip Code:92882-5303
Practice Address - Country:US
Practice Address - Phone:951-279-1333
Practice Address - Fax:951-279-5222
Is Sole Proprietor?:No
Enumeration Date:2014-07-01
Last Update Date:2016-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALMFT 94839106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist