Provider Demographics
NPI:1801268552
Name:DOUKAS, HEYLEENKEN (LMFT)
Entity type:Individual
Prefix:
First Name:HEYLEENKEN
Middle Name:
Last Name:DOUKAS
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:HEYLEENKEN
Other - Middle Name:
Other - Last Name:ESTRADA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:21732 S VERMONT AVE STE 210
Mailing Address - Street 2:
Mailing Address - City:TORRANCE
Mailing Address - State:CA
Mailing Address - Zip Code:90502-2180
Mailing Address - Country:US
Mailing Address - Phone:213-544-6497
Mailing Address - Fax:
Practice Address - Street 1:19401 S VERMONT AVE STE A200
Practice Address - Street 2:
Practice Address - City:TORRANCE
Practice Address - State:CA
Practice Address - Zip Code:90502-4418
Practice Address - Country:US
Practice Address - Phone:310-323-6887
Practice Address - Fax:310-436-8285
Is Sole Proprietor?:No
Enumeration Date:2015-10-21
Last Update Date:2024-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALMFT114809106H00000X
101YM0800X, 106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health