Provider Demographics
NPI:1003196544
Name:FRIEDMAN, CHERYL (PSYD)
Entity Type:Individual
Prefix:DR
First Name:CHERYL
Middle Name:
Last Name:FRIEDMAN
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:23046 AVENIDA DE LA CARLOTA
Mailing Address - Street 2:SUITE 648
Mailing Address - City:LAGUNA HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:92653-1548
Mailing Address - Country:US
Mailing Address - Phone:949-588-5778
Mailing Address - Fax:949-588-5774
Practice Address - Street 1:23046 AVENIDA DE LA CARLOTA
Practice Address - Street 2:SUITE 648
Practice Address - City:LAGUNA HILLS
Practice Address - State:CA
Practice Address - Zip Code:92653-1548
Practice Address - Country:US
Practice Address - Phone:949-588-5778
Practice Address - Fax:949-588-5774
Is Sole Proprietor?:Yes
Enumeration Date:2011-08-27
Last Update Date:2011-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CARP 213102L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes102L00000XBehavioral Health & Social Service ProvidersPsychoanalyst
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA45-3093546OtherEIN