Healthcare Provider Details

I. General information

NPI: 1003196544
Provider Name (Legal Business Name): CHERYL FRIEDMAN PSY.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/27/2011
Last Update Date: 08/27/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

23046 AVENIDA DE LA CARLOTA SUITE 648
LAGUNA HILLS CA
92653-1548
US

IV. Provider business mailing address

23046 AVENIDA DE LA CARLOTA SUITE 648
LAGUNA HILLS CA
92653-1548
US

V. Phone/Fax

Practice location:
  • Phone: 949-588-5778
  • Fax: 949-588-5774
Mailing address:
  • Phone: 949-588-5778
  • Fax: 949-588-5774

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code102L00000X
TaxonomyPsychoanalyst
License NumberRP 213
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: