Provider Demographics
NPI:1710394218
Name:BURTON, HEATHER CHRISTINE (PSYD)
Entity Type:Individual
Prefix:DR
First Name:HEATHER
Middle Name:CHRISTINE
Last Name:BURTON
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2601 AIRPORT DR # 135
Mailing Address - Street 2:
Mailing Address - City:TORRANCE
Mailing Address - State:CA
Mailing Address - Zip Code:90505-6140
Mailing Address - Country:US
Mailing Address - Phone:424-201-1600
Mailing Address - Fax:
Practice Address - Street 1:1000 WILSHIRE BLVD # 240
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90017-2457
Practice Address - Country:US
Practice Address - Phone:424-201-1600
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-07-16
Last Update Date:2018-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY29023103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical