Healthcare Provider Details

I. General information

NPI: 1154270809
Provider Name (Legal Business Name): CLARA FRIEDMAN
Entity Type: Individual
Gender:
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/26/2026
Last Update Date: 01/26/2026
Certification Date: 01/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

380 MINOR LN
BERKELEY CA
94720-0001
US

IV. Provider business mailing address

380 MINOR LN
BERKELEY CA
94720-0001
US

V. Phone/Fax

Practice location:
  • Phone: 510-642-2020
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License Number36167
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: