Healthcare Provider Details

I. General information

NPI: 1316633290
Provider Name (Legal Business Name): SYDNEY MARIE FRIERA CATC-II
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/13/2023
Last Update Date: 09/24/2026
Certification Date: 09/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3789 HOOVER ST
REDWOOD CITY CA
94063-4504
US

IV. Provider business mailing address

1060 CONTINENTALS WAY APT 117
BELMONT CA
94002-3151
US

V. Phone/Fax

Practice location:
  • Phone: 650-363-8735
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number24357
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code175T00000X
TaxonomyPeer Specialist
License NumberMPSS-PFSHTB
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: