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General NPI Number Information
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NPI Number | 1861668469
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Entity Type | Individual
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Provider Name | JEFFREY STEVEN FRIEDMAN PH.D.
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Gender | Male
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Dates
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Enumeration Date | 05/03/2008
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Last Update Date | 05/01/2014
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Provider Practice Location Address
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Address Line | 956 WALNUT ST STE 200
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City | SAN LUIS OBISPO
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State | CA
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Zip | 93401-1707
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Country | US
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Telephone | 805-545-9410
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Fax | 805-545-9476
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Provider Business Mailing Address
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Address Line | 956 WALNUT ST STE 200
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City | SAN LUIS OBISPO
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State | CA
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Zip | 93401-1707
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Country | US
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Telephone | 805-545-9410
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Fax | 805-545-9476
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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 | 103T00000X
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Taxonomy Name | Psychologist
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License Number | PSY9763
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License Number State | CA
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