Individual provider Active NPI

Mariam Tsaturyan, PSY.D.

  • Psychologist
  • Glendale, CA
National Provider Identifier
1811089832
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
PSY18996 Issued in CA
Practice address
300 W Glenoaks Blvd Ste 105
Glendale, CA 91202-3084
Phone
(818) 409-9917
Fax
(818) 755-3181
NPI assigned
Sep 28, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X PSY18996 CA Primary

Addresses

Primary practice location

300 W Glenoaks Blvd Ste 105
Glendale, CA 91202-3084

Mailing address

300 W Glenoaks Blvd Ste 105
Glendale, CA 91202-3084
Phone (818) 409-9917

Other identifiers 1

IdentifierTypeStateIssuer
335015OtherCAMHN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040813000542 CA Practitioner - Clinical Psychologist 3072586585 Practice locations: Glendale, CA

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
NA&TJ Inc CurrentSince Jul 24, 2022 Accepting new patients

Locations

300 W Glenoaks Blvd
Ste 105
Glendale, CA 91202
Phone (818) 409-9917

Organizations & group practices 1

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": "1159401600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1811089832",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 W GLENOAKS BLVD STE 105",
            "city": "GLENDALE",
            "state": "CA",
            "postal_code": "912023084",
            "telephone_number": "818-409-9917",
            "fax_number": "818-755-3181"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 W GLENOAKS BLVD STE 105",
            "city": "GLENDALE",
            "state": "CA",
            "postal_code": "912023084",
            "telephone_number": "818-409-9917",
            "fax_number": "818-755-3181"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TSATURYAN",
        "first_name": "MARIAM",
        "name_prefix": "Dr.",
        "credential": "PSY.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-09-28",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "CA",
            "license": "PSY18996",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MHN",
            "identifier": "335015",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Glendale, CA

Sources for this page

Verify at the official NPI Registry.