Healthcare Provider Details

I. General information

NPI: 1710574827
Provider Name (Legal Business Name): AMANY AL-SAYYED
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/22/2020
Last Update Date: 12/22/2020
Certification Date: 12/11/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10532 ACACIA ST STE B4
RANCHO CUCAMONGA CA
91730-5455
US

IV. Provider business mailing address

41 E FOOTHILL BLVD STE 102
ARCADIA CA
91006-2361
US

V. Phone/Fax

Practice location:
  • Phone: 909-325-3766
  • Fax: 626-737-6034
Mailing address:
  • Phone: 626-701-4249
  • Fax: 626-737-6034

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number98460
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: