Healthcare Provider Details

I. General information

NPI: 1023598208
Provider Name (Legal Business Name): ANASHEH ANNA AMIRIYAN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/17/2018
Last Update Date: 09/29/2026
Certification Date: 09/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

28963 SAM PL
SANTA CLARITA CA
91387
US

IV. Provider business mailing address

28963 SAM PL
SANTA CLARITA CA
91387-1878
US

V. Phone/Fax

Practice location:
  • Phone: 818-967-0866
  • Fax:
Mailing address:
  • Phone: 818-967-0866
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number124659
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: