MEDICARE: MS. NANCY M. FRIEDMAN MA, MFT

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	MFT 12615	CA

General Provider Information

NPI Number	:	1841417979
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. NANCY M. FRIEDMAN MA, MFT

Provider Business Mailing Address
First Line	:	631 VERNON ST
Second Line	:
City	:	OAKLAND
State	:	CA
Zip	:	94610-1419
Country	:	US
Telephone Number	:	510-653-1384
Fax Number	:	510-653-9021

Provider Business Practice Location Address
First Line	:	631 VERNON ST
Second Line	:
City	:	OAKLAND
State	:	CA
Zip	:	94610-1419
Country	:	US
Telephone Number	:	510-653-1384
Fax Number	:	510-653-9021

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

Provider Enumeration Date	:	04/19/2007
Last Update Date	:	07/08/2007

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