MEDICARE: SHOSHANA FRIEDMAN-HAWK

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	374J00000X	Doula

General Provider Information

NPI Number	:	1225566243
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SHOSHANA FRIEDMAN-HAWK

Provider Business Mailing Address
First Line	:	1090 MILLER AVE
Second Line	:
City	:	BERKELEY
State	:	CA
Zip	:	94708-1516
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1090 MILLER AVE
Second Line	:
City	:	BERKELEY
State	:	CA
Zip	:	94708-1516
Country	:	US
Telephone Number	:	510-209-3996
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/03/2017
Last Update Date	:	06/03/2017

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