Provider Demographics
NPI:1154709285
Name:SAIDIAN, MIRIAM
Entity type:Individual
Prefix:
First Name:MIRIAM
Middle Name:
Last Name:SAIDIAN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6737 BRIGHT AVE
Mailing Address - Street 2:#101
Mailing Address - City:WHITTIER
Mailing Address - State:CA
Mailing Address - Zip Code:90601-4300
Mailing Address - Country:US
Mailing Address - Phone:310-773-7997
Mailing Address - Fax:
Practice Address - Street 1:6737 BRIGHT AVE
Practice Address - Street 2:#101
Practice Address - City:WHITTIER
Practice Address - State:CA
Practice Address - Zip Code:90601-4300
Practice Address - Country:US
Practice Address - Phone:310-773-7997
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-05-08
Last Update Date:2015-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAIMF84210106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist