Provider Demographics
NPI:1841019072
Name:ACHARYA, NIYANTA (AMFT)
Entity type:Individual
Prefix:MS
First Name:NIYANTA
Middle Name:
Last Name:ACHARYA
Suffix:
Gender:F
Credentials:AMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10935 PEACH GROVE ST APT 3
Mailing Address - Street 2:
Mailing Address - City:NORTH HOLLYWOOD
Mailing Address - State:CA
Mailing Address - Zip Code:91601-4657
Mailing Address - Country:US
Mailing Address - Phone:818-301-4369
Mailing Address - Fax:
Practice Address - Street 1:10935 PEACH GROVE ST APT 3
Practice Address - Street 2:
Practice Address - City:NORTH HOLLYWOOD
Practice Address - State:CA
Practice Address - Zip Code:91601-4657
Practice Address - Country:US
Practice Address - Phone:818-301-4369
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-10-04
Last Update Date:2024-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAMFT149601106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist