Provider Demographics
NPI:1164734968
Name:NOURIAN, SHAGHAYEGH SHERRY (PSYD)
Entity Type:Individual
Prefix:DR
First Name:SHAGHAYEGH
Middle Name:SHERRY
Last Name:NOURIAN
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18960 VENTURA BLVD STE 2
Mailing Address - Street 2:
Mailing Address - City:TARZANA
Mailing Address - State:CA
Mailing Address - Zip Code:91356-3224
Mailing Address - Country:US
Mailing Address - Phone:818-851-1197
Mailing Address - Fax:
Practice Address - Street 1:5146 TOPANGA CANYON BLVD
Practice Address - Street 2:
Practice Address - City:WOODLAND HILLS
Practice Address - State:CA
Practice Address - Zip Code:91364
Practice Address - Country:US
Practice Address - Phone:818-851-1197
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-07-08
Last Update Date:2023-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY26240103TC0700X, 103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
No103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical