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General NPI Number Information
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NPI Number | 1659404127
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Entity Type | Individual
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Provider Name | GARY FREEDMAN-HARVEY PH.D.
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Gender | Male
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Dates
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Enumeration Date | 03/14/2007
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Last Update Date | 07/09/2007
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Provider Practice Location Address
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Address Line | 909 ELECTRIC AVE STE 202
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City | SEAL BEACH
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State | CA
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Zip | 90740-6336
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Country | US
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Telephone | 562-493-2244
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Fax | 562-493-0644
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Provider Business Mailing Address
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Address Line | 909 ELECTRIC AVE STE 202
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City | SEAL BEACH
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State | CA
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Zip | 90740-6336
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Country | US
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Telephone | 562-493-2244
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Fax | 562-493-0644
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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 | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | PSY11419
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License Number State | CA
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