Clementine Malibu Lake - Mental Health Clinic in Agoura Hills, CA

Clementine Malibu Lake is a mental health clinic (Clinic/center - Adolescent And Children Mental Health) in Agoura Hills, California. The current practice location for Clementine Malibu Lake is 29470 Lake Vista Dr, Agoura Hills, California. For appointments, you can reach them via phone at (747) 212-5021. The mailing address for Clementine Malibu Lake is 6100 Sw 76th St, South Miami, Florida and phone number is (305) 663-1876.

Clementine Malibu Lake is licensed to practice in * (Not Available) (license number ) and its NPI number is 1780105551. This medical practice does not participate in medicare program and thus may not accept your medicare insurance. You may check if they accept your insurance at (747) 212-5021.

Contact Information

Clementine Malibu Lake
29470 Lake Vista Dr
Agoura Hills
CA 91301-2818
(747) 212-5021
(818) 575-7327

Mental Health Clinic Profile

Full NameClementine Malibu Lake
SpecialityClinic/center - Adolescent And Children Mental Health
Location29470 Lake Vista Dr, Agoura Hills, California
Authorized Official Name and PositionMike Bagley (CHIEF FINANCIAL OFFICER)
Authorized Official Contact3056631876
Accepts Medicare InsuranceThis clinic does not participate in Medicare Program.

Mailing Address and Practice Location

Mailing AddressPractice Location Address
Clementine Malibu Lake
6100 Sw 76th St
South Miami
FL 33143-5002

Ph: (305) 663-1876
Clementine Malibu Lake
29470 Lake Vista Dr
Agoura Hills
CA 91301-2818

Ph: (747) 212-5021

NPI Details:

NPI Number1780105551
Provider Enumeration Date07/03/2017
Last Update Date05/27/2020
Certification Date05/27/2020

Medical Identifiers

Medical identifiers for Clementine Malibu Lake such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1780105551NPI-NPPES

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
261QM0855XClinic/center - Adolescent And Children Mental Health (* (Not Available))Primary

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