Healthcare Provider Details

I. General information

NPI: 1740590439
Provider Name (Legal Business Name): LYNNE FRIEDMAN-GELL PH.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/14/2010
Last Update Date: 10/17/2021
Certification Date: 10/17/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

14156 MAGNOLIA BLVD STE 200
SHERMAN OAKS CA
91423-1182
US

IV. Provider business mailing address

14156 MAGNOLIA BLVD STE 200
SHERMAN OAKS CA
91423-1182
US

V. Phone/Fax

Practice location:
  • Phone: 310-570-0060
  • Fax:
Mailing address:
  • Phone: 310-570-0060
  • Fax: 818-474-7646

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103T00000X
TaxonomyPsychologist
License Number22107
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code103TA0400X
TaxonomyAddiction (Substance Use Disorder) Psychologist
License Number22107
License Number StateCA
# 3
Primary TaxonomyN
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number22107
License Number StateCA
# 4
Primary TaxonomyN
Taxonomy Code103TC2200X
TaxonomyClinical Child & Adolescent Psychologist
License Number22107
License Number StateCA
# 5
Primary TaxonomyN
Taxonomy Code103TF0000X
TaxonomyFamily Psychologist
License Number22107
License Number StateCA
# 6
Primary TaxonomyN
Taxonomy Code103TP2701X
TaxonomyGroup Psychotherapy Psychologist
License Number22107
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: