Provider Demographics
NPI:1912874462
Name:AVIRAM, MEIRAV MAY (MA)
Entity type:Individual
Prefix:
First Name:MEIRAV
Middle Name:MAY
Last Name:AVIRAM
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18625 TOPHAM ST
Mailing Address - Street 2:
Mailing Address - City:TARZANA
Mailing Address - State:CA
Mailing Address - Zip Code:91335-6804
Mailing Address - Country:US
Mailing Address - Phone:818-822-4477
Mailing Address - Fax:
Practice Address - Street 1:16255 VENTURA BLVD STE 806
Practice Address - Street 2:
Practice Address - City:ENCINO
Practice Address - State:CA
Practice Address - Zip Code:91436-2317
Practice Address - Country:US
Practice Address - Phone:818-822-4477
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-10-20
Last Update Date:2025-10-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA120152101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty