Active NPI
Shirin Ghiyam
- Psychologist
- Encino, CA
National Provider Identifier
1346625035
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychologist
- License
- LMFT91196
- Practice address
- 16661 Ventura Blvd
Encino, CA 91436-1914 - Phone
- (805) 368-2063
- NPI assigned
- Jul 23, 2015
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychologist | 103T00000X | IMF87702 | CA | |
| Psychologist | 103T00000X | LMFT91196 | CA | Primary |
Addresses
Primary practice location
16661 Ventura Blvd
Encino, CA 91436-1914
Mailing address
630 Cricketfield CT
Lake Sherwood, CA 91361-5156
Phone (805) 368-2063
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| IMF87702 | CA | MD | Psychologist |
| LMFT91196 | CA | MD | Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1437609600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1479340800000",
"number": "1346625035",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "630 CRICKETFIELD CT",
"city": "LAKE SHERWOOD",
"state": "CA",
"postal_code": "913615156",
"telephone_number": "805-368-2063"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "16661 VENTURA BLVD",
"city": "ENCINO",
"state": "CA",
"postal_code": "914361914",
"telephone_number": "805-368-2063"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GHIYAM",
"first_name": "SHIRIN",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2015-07-23",
"last_updated": "2016-11-17",
"status": "A"
},
"taxonomies": [
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "CA",
"license": "IMF87702",
"primary": false
},
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "CA",
"license": "LMFT91196",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Encino, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 17, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.