Healthcare Provider Details

I. General information

NPI: 1629908207
Provider Name (Legal Business Name): HEARTLIGHT HEALING COLLECTIVE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/23/2026
Last Update Date: 05/23/2026
Certification Date: 05/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

543 COUNTRY CLUB DR # 403
SIMI VALLEY CA
93065-0637
US

IV. Provider business mailing address

543 COUNTRY CLUB DRIVE STE B #403
SIMI VALLEY CA
93065
US

V. Phone/Fax

Practice location:
  • Phone: 310-426-8118
  • Fax:
Mailing address:
  • Phone: 310-426-8118
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number
License Number State

VIII. Authorized Official

Name: MEGAN FEHTE
Title or Position: OWNER
Credential:
Phone: 818-517-6790