Provider Demographics
NPI:1770831042
Name:LAY, SYDNEY FARID (LCSW)
Entity Type:Individual
Prefix:
First Name:SYDNEY
Middle Name:FARID
Last Name:LAY
Suffix:
Gender:M
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3991 WILD SIENNA TRL
Mailing Address - Street 2:
Mailing Address - City:HEMET
Mailing Address - State:CA
Mailing Address - Zip Code:92545-6395
Mailing Address - Country:US
Mailing Address - Phone:951-282-2696
Mailing Address - Fax:
Practice Address - Street 1:3991 WILD SIENNA TRL
Practice Address - Street 2:
Practice Address - City:HEMET
Practice Address - State:CA
Practice Address - Zip Code:92545-6395
Practice Address - Country:US
Practice Address - Phone:951-282-2696
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-08-17
Last Update Date:2012-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALCS 274561041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical