Healthcare Provider Details

I. General information

NPI: 1477491355
Provider Name (Legal Business Name): CAROLYN FRIEND
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/23/2026
Last Update Date: 03/23/2026
Certification Date: 03/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5335 CRANER AVE
NORTH HOLLYWOOD CA
91601-3313
US

IV. Provider business mailing address

2457 ENDICOTT ST
LOS ANGELES CA
90032-3047
US

V. Phone/Fax

Practice location:
  • Phone: 818-927-4045
  • Fax: 818-927-4016
Mailing address:
  • Phone: 323-221-5177
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code373H00000X
TaxonomyDay Training/Habilitation Specialist
License Number
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: