Provider Demographics
NPI:1902936313
Name:AKIATEN, EILEEN FAYE (MA, MFT)
Entity Type:Individual
Prefix:MS
First Name:EILEEN
Middle Name:FAYE
Last Name:AKIATEN
Suffix:
Gender:F
Credentials:MA, MFT
Other - Prefix:MS
Other - First Name:EILEEN
Other - Middle Name:FAYE
Other - Last Name:AKIATEN
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LMFT
Mailing Address - Street 1:5054 S VERMONT AVE
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90037-2946
Mailing Address - Country:US
Mailing Address - Phone:323-373-2444
Mailing Address - Fax:
Practice Address - Street 1:5054 S VERMONT AVE
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90037-2946
Practice Address - Country:US
Practice Address - Phone:323-373-2444
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-03-06
Last Update Date:2020-12-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFC50587106H00000X
CALMFT50587106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist