Provider Demographics
NPI:1326938739
Name:LEBOW, ALYSON SMITH (PYSCHOLOGICAL ASSOC)
Entity type:Individual
Prefix:
First Name:ALYSON
Middle Name:SMITH
Last Name:LEBOW
Suffix:
Gender:F
Credentials:PYSCHOLOGICAL ASSOC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4064 MIRALESTE DR
Mailing Address - Street 2:
Mailing Address - City:RANCHO PALOS VERDES
Mailing Address - State:CA
Mailing Address - Zip Code:90275-6525
Mailing Address - Country:US
Mailing Address - Phone:952-288-6638
Mailing Address - Fax:
Practice Address - Street 1:2660 SOLACE PL STE D2
Practice Address - Street 2:
Practice Address - City:MOUNTAIN VIEW
Practice Address - State:CA
Practice Address - Zip Code:94040-4337
Practice Address - Country:US
Practice Address - Phone:424-262-5980
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-07-07
Last Update Date:2025-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA94028989103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist