Provider Demographics
NPI:1538620315
Name:MEHDI, SYED SHAYAN
Entity type:Individual
Prefix:
First Name:SYED
Middle Name:SHAYAN
Last Name:MEHDI
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1450 STEEL CREEK DR
Mailing Address - Street 2:
Mailing Address - City:PATTERSON
Mailing Address - State:CA
Mailing Address - Zip Code:95363-8774
Mailing Address - Country:US
Mailing Address - Phone:510-579-2150
Mailing Address - Fax:
Practice Address - Street 1:1450 STEEL CREEK DR
Practice Address - Street 2:
Practice Address - City:PATTERSON
Practice Address - State:CA
Practice Address - Zip Code:95363-8774
Practice Address - Country:US
Practice Address - Phone:510-579-2150
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-03-26
Last Update Date:2025-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALMFT137397106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist