MEDICARE: SANFORD L. FRIEDLANDER

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	106H00000X	Marriage & Family Therapist	MFC 34501	CA

General Provider Information

NPI Number	:	1003090440
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SANFORD L. FRIEDLANDER

Provider Business Mailing Address
First Line	:	1264 HIGUERA ST
Second Line	:	SUITE 208
City	:	SAN LUIS OBISPO
State	:	CA
Zip	:	93401-3124
Country	:	US
Telephone Number	:	805-543-5301
Fax Number	:

Provider Business Practice Location Address
First Line	:	1264 HIGUERA ST
Second Line	:	SUITE 208
City	:	SAN LUIS OBISPO
State	:	CA
Zip	:	93401-3124
Country	:	US
Telephone Number	:	805-543-5301
Fax Number	:

Authorized Official
Title or Position	:	DIRECTOR/OWNER
Name	:	MR. SANFORD LOUIS FRIEDLANDER
Credential	:	LMFT
Telephone Number	:	805-543-5301

Provider Enumeration Date	:	12/20/2007
Last Update Date	:	06/15/2015

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