Provider Demographics
NPI:1609688696
Name:SAHAKYAN, MARIAM (FNP)
Entity type:Individual
Prefix:
First Name:MARIAM
Middle Name:
Last Name:SAHAKYAN
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6625 WILBUR AVE UNIT 17
Mailing Address - Street 2:
Mailing Address - City:RESEDA
Mailing Address - State:CA
Mailing Address - Zip Code:91335-5159
Mailing Address - Country:US
Mailing Address - Phone:323-533-7382
Mailing Address - Fax:
Practice Address - Street 1:6625 WILBUR AVE UNIT 17
Practice Address - Street 2:
Practice Address - City:RESEDA
Practice Address - State:CA
Practice Address - Zip Code:91335-5159
Practice Address - Country:US
Practice Address - Phone:323-533-7382
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-01-25
Last Update Date:2025-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CANP95031033207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine