Provider Demographics
NPI:1669539250
Name:SAYYEDI, MARYAM (PHD)
Entity type:Individual
Prefix:MRS
First Name:MARYAM
Middle Name:
Last Name:SAYYEDI
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2101 BUSINESS CENTER DR STE 150
Mailing Address - Street 2:
Mailing Address - City:IRVINE
Mailing Address - State:CA
Mailing Address - Zip Code:92612-1022
Mailing Address - Country:US
Mailing Address - Phone:949-502-4721
Mailing Address - Fax:
Practice Address - Street 1:2101 BUSINESS CENTER DR STE 150
Practice Address - Street 2:
Practice Address - City:IRVINE
Practice Address - State:CA
Practice Address - Zip Code:92612-1022
Practice Address - Country:US
Practice Address - Phone:949-509-4721
Practice Address - Fax:714-665-2731
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-02
Last Update Date:2024-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY17273103TC2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC2200XBehavioral Health & Social Service ProvidersPsychologistClinical Child & Adolescent