Healthcare Provider Details

I. General information

NPI: 1669539250
Provider Name (Legal Business Name): MARYAM SAYYEDI PH.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/02/2007
Last Update Date: 04/27/2026
Certification Date: 04/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2101 BUSINESS CENTER DR STE 150
IRVINE CA
92612-1022
US

IV. Provider business mailing address

2101 BUSINESS CENTER DR STE 150
IRVINE CA
92612-1022
US

V. Phone/Fax

Practice location:
  • Phone: 949-509-4721
  • Fax: 714-665-2731
Mailing address:
  • Phone: 949-502-4721
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License NumberPSY17273
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: