Healthcare Provider Details

I. General information

NPI: 1467370031
Provider Name (Legal Business Name): HEATHER GLENN EATON LMFT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/09/2026
Last Update Date: 07/09/2026
Certification Date: 07/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

17547 HIAWATHA ST
GRANADA HILLS CA
91344-6002
US

IV. Provider business mailing address

17547 HIAWATHA ST
GRANADA HILLS CA
91344-6002
US

V. Phone/Fax

Practice location:
  • Phone: 818-518-4469
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberMFT41495
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: