Healthcare Provider Details

I. General information

NPI: 1972412658
Provider Name (Legal Business Name): ERICA EMMA CANNON MFT/PCC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

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

III. Provider practice location address

20350 VENTURA BLVD STE 200
WOODLAND HILLS CA
91364-2461
US

IV. Provider business mailing address

6099 CRAPE MYRTLE CT
WOODLAND HILLS CA
91367-7217
US

V. Phone/Fax

Practice location:
  • Phone: 760-450-5549
  • Fax:
Mailing address:
  • Phone: 760-450-5549
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: