Healthcare Provider Details

I. General information

NPI: 1093531949
Provider Name (Legal Business Name): HANIYA SALEEM SYEDA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/25/2024
Last Update Date: 04/23/2025
Certification Date: 04/23/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

14112 S KINGSLEY DR
GARDENA CA
90249-3018
US

IV. Provider business mailing address

3540 DUNN DR APT 10
LOS ANGELES CA
90034-7571
US

V. Phone/Fax

Practice location:
  • Phone: 310-217-7312
  • Fax:
Mailing address:
  • Phone: 857-615-9141
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberASW125236
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code1041S0200X
TaxonomySchool Social Worker
License Number
License Number StateNULL
# 3
Primary TaxonomyN
Taxonomy Code102L00000X
TaxonomyPsychoanalyst
License Number
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: