Provider Demographics
NPI:1508655119
Name:CHILINGARYAN, MARIAM
Entity type:Individual
Prefix:DR
First Name:MARIAM
Middle Name:
Last Name:CHILINGARYAN
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5501 LAUREL CANYON BLVD APT 300
Mailing Address - Street 2:
Mailing Address - City:NORTH HOLLYWOOD
Mailing Address - State:CA
Mailing Address - Zip Code:91607-0005
Mailing Address - Country:US
Mailing Address - Phone:213-880-4125
Mailing Address - Fax:
Practice Address - Street 1:5501 LAUREL CANYON BLVD APT 300
Practice Address - Street 2:
Practice Address - City:NORTH HOLLYWOOD
Practice Address - State:CA
Practice Address - Zip Code:91607-0005
Practice Address - Country:US
Practice Address - Phone:213-880-4125
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-05-01
Last Update Date:2025-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA35862103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical