Healthcare Provider Details

I. General information

NPI: 1407792195
Provider Name (Legal Business Name): MARYAM SARKEES
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/27/2026
Last Update Date: 04/27/2026
Certification Date: 04/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

336 N CHEVY CHASE DR APT 7
GLENDALE CA
91206-5064
US

IV. Provider business mailing address

336 N CHEVY CHASE DR APT 7
GLENDALE CA
91206-5064
US

V. Phone/Fax

Practice location:
  • Phone: 323-523-3334
  • Fax:
Mailing address:
  • Phone: 323-523-3334
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number2025096161
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: