Healthcare Provider Details

I. General information

NPI: 1538098892
Provider Name (Legal Business Name): SHARMILA IYENGAR
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/14/2026
Last Update Date: 05/14/2026
Certification Date: 05/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4111 LAS VIRGENES RD
CALABASAS CA
91302-1886
US

IV. Provider business mailing address

30856 AGOURA RD APT H9
AGOURA HILLS CA
91301-4309
US

V. Phone/Fax

Practice location:
  • Phone: 818-880-4000
  • Fax:
Mailing address:
  • Phone: 310-415-8166
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: