MEDICARE: TAMI FRIEDKIN M.F.T

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	101YM0800X	Mental Health Counselor	M.F.T 39784	CA

General Provider Information

NPI Number	:	1629291109
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	TAMI FRIEDKIN M.F.T

Provider Business Mailing Address
First Line	:	11415 ROCHESTER AVE APT 14
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90025-7828
Country	:	US
Telephone Number	:	310-473-0019
Fax Number	:

Provider Business Practice Location Address
First Line	:	14724 VENTURA BLVD STE 1100
Second Line	:
City	:	SHERMAN OAKS
State	:	CA
Zip	:	91403-3511
Country	:	US
Telephone Number	:	310-473-0019
Fax Number	:

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

Provider Enumeration Date	:	04/11/2007
Last Update Date	:	07/08/2007

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