Healthcare Provider Details

I. General information

NPI: 1275457384
Provider Name (Legal Business Name): BROOKE FRIEDBERG
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: BROOKE BULLER

II. Dates (important events)

Enumeration Date: 08/10/2026
Last Update Date: 08/10/2026
Certification Date: 08/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2309 PACIFIC COAST HWY
HERMOSA BEACH CA
90254-2751
US

IV. Provider business mailing address

13721 PURCHE AVE
GARDENA CA
90249-2334
US

V. Phone/Fax

Practice location:
  • Phone: 424-558-4181
  • Fax:
Mailing address:
  • Phone: 424-558-4181
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: