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General NPI Number Information
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NPI Number | 1255563896
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Entity Type | Individual
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Provider Name | DIANE B. FRIEDERICH M.A., CCC-SLP
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Gender | Female
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Dates
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Enumeration Date | 08/16/2009
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Last Update Date | 08/16/2009
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Provider Practice Location Address
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Address Line | 25405 HANCOCK AVE SUITE 200
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City | MURRIETA
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State | CA
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Zip | 92562-5982
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Country | US
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Telephone | 951-696-4308
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Fax | 951-696-4309
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Provider Business Mailing Address
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Address Line | PO BOX 538
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City | TEMECULA
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State | CA
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Zip | 92593-0538
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Country | US
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Telephone | 951-491-5566
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 235Z00000X
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Taxonomy Name | Speech-Language Pathologist
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License Number | 9168
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License Number State | CA
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