Active NPI
Sanam Abrishami
- Clinical Psychologist
- Los Angeles, CA
National Provider Identifier
1861622276
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- PSY26105
- Practice address
- 11965 Venice Blvd Ste 202
Los Angeles, CA 90066-3954 - Phone
- (818) 896-1161
- NPI assigned
- Jul 20, 2009
- Last updated
- Jun 18, 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | PSY26105 | CA | Primary |
Addresses
Primary practice location
11965 Venice Blvd Ste 202
Los Angeles, CA 90066-3954
Mailing address
1171 S Robertson Blvd # 104
Los Angeles, CA 90035-1403
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 |
|---|---|---|---|
| PSY26105 | CA | MD | Clinical Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1248048000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1434585600000",
"number": "1861622276",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1171 S ROBERTSON BLVD # 104",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "900351403"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "11965 VENICE BLVD STE 202",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "900663954",
"telephone_number": "818-896-1161"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ABRISHAMI",
"first_name": "SANAM",
"name_prefix": "Dr.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2009-07-20",
"last_updated": "2015-06-18",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "CA",
"license": "PSY26105",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Los Angeles, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 18, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.