Individual provider Active NPI

Mariam Ter-Petrosyan

  • Psychologist
  • Van Nuys, CA
National Provider Identifier
1609287440
Registry record updated Sep 8, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
31182 Issued in CA
Practice address
17620 Sherman Way Ste 210
Van Nuys, CA 91406-3527
Phone
(818) 568-4185
NPI assigned
May 14, 2014
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 8, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X 31182 CA Primary

Addresses

Primary practice location

17620 Sherman Way Ste 210
Van Nuys, CA 91406-3527

Mailing address

17620 Sherman Way Ste 210
Van Nuys, CA 91406-3527
Phone (818) 568-4185

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)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Beacon Home Health LLC Current Accepting new patients
WK Medical Group PastSince Apr 6, 2016 Accepting new patients
Los Gatos Therapy Center PastSince Apr 17, 2022 Accepting new patients
LGTC Group Psychologist PastSince May 20, 2025 Accepting new patients

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1400025600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1788825600000",
    "number": "1609287440",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17620 SHERMAN WAY STE 210",
            "city": "VAN NUYS",
            "state": "CA",
            "postal_code": "914063527",
            "telephone_number": "818-568-4185"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17620 SHERMAN WAY STE 210",
            "city": "VAN NUYS",
            "state": "CA",
            "postal_code": "914063527",
            "telephone_number": "818-568-4185"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TER-PETROSYAN",
        "first_name": "MARIAM",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-05-14",
        "last_updated": "2026-09-08",
        "certification_date": "2026-09-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "CA",
            "license": "31182",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Van Nuys, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 8, 2026; 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.