Provider Demographics
NPI:1053812354
Name:MIGONE, DANTE
Entity type:Individual
Prefix:
First Name:DANTE
Middle Name:
Last Name:MIGONE
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:32107 LINDERO CANYON RD STE 229
Mailing Address - Street 2:
Mailing Address - City:WESTLAKE VILLAGE
Mailing Address - State:CA
Mailing Address - Zip Code:91361-4266
Mailing Address - Country:US
Mailing Address - Phone:818-851-9213
Mailing Address - Fax:
Practice Address - Street 1:32107 LINDERO CANYON RD STE 229
Practice Address - Street 2:
Practice Address - City:WESTLAKE VILLAGE
Practice Address - State:CA
Practice Address - Zip Code:91361-4266
Practice Address - Country:US
Practice Address - Phone:818-851-9213
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-02-22
Last Update Date:2023-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA1-23-65667103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst