Healthcare Provider Details

I. General information

NPI: 1821992397
Provider Name (Legal Business Name): NARISHIA LAYE
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/07/2026
Last Update Date: 10/07/2026
Certification Date: 10/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2248 SHERIDAN RD
SAN BERNARDINO CA
92407-2444
US

IV. Provider business mailing address

6155 PALM AVE APT 3408
SAN BERNARDINO CA
92407-2094
US

V. Phone/Fax

Practice location:
  • Phone: 909-273-4029
  • Fax:
Mailing address:
  • Phone: 909-273-4029
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101Y00000X
TaxonomyCounselor
License NumberAPCC23247
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: