Provider Demographics
NPI:1902417355
Name:CARVALHO-MIRES, ARYANA
Entity Type:Individual
Prefix:
First Name:ARYANA
Middle Name:
Last Name:CARVALHO-MIRES
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 1:11500 W OLYMPIC BLVD STE 415
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90064-1536
Mailing Address - Country:US
Mailing Address - Phone:424-225-1845
Mailing Address - Fax:310-933-4803
Practice Address - Street 1:11500 W OLYMPIC BLVD STE 415
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90064-1536
Practice Address - Country:US
Practice Address - Phone:424-225-1845
Practice Address - Fax:310-933-4803
Is Sole Proprietor?:Yes
Enumeration Date:2020-08-10
Last Update Date:2020-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA2986892251N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251N0400XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistNeurology