Miraya Surya-Keller

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

136145 Issued in CA

Practice address

5927 Cantaloupe Ave
Valley Glen, CA 91401-4313

Phone

(213) 863-5056

NPI assigned

Sep 21, 2024

Last updated

Sep 21, 2024By the provider in NPPES

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1726876800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1726876800000",
    "number": "1306663323",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19161 ERWIN ST",
            "city": "TARZANA",
            "state": "CA",
            "postal_code": "913356707",
            "telephone_number": "818-425-8027"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5927 CANTALOUPE AVE",
            "city": "VALLEY GLEN",
            "state": "CA",
            "postal_code": "914014313",
            "telephone_number": "213-863-5056"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SURYA-KELLER",
        "first_name": "MIRAYA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-09-21",
        "last_updated": "2024-09-21",
        "certification_date": "2024-09-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "CA",
            "license": "136145",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Mental Health Counselor in Valley Glen, CA
• Providers in Valley Glen, CA by specialty
• Mental Health Counselor in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 21, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.