Provider Demographics
NPI:1013025899
Name:FRIEDMANN, LOLA J (MA MFC)
Entity Type:Individual
Prefix:MS
First Name:LOLA
Middle Name:J
Last Name:FRIEDMANN
Suffix:
Gender:F
Credentials:MA MFC
Other - Prefix:
Other - First Name:LEOLA
Other - Middle Name:
Other - Last Name:MACKIE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:101 W BRANCH
Mailing Address - Street 2:#2
Mailing Address - City:ARROYO GRANDE
Mailing Address - State:CA
Mailing Address - Zip Code:93420
Mailing Address - Country:US
Mailing Address - Phone:805-481-8662
Mailing Address - Fax:805-481-8662
Practice Address - Street 1:101 W BRANCH ST
Practice Address - Street 2:#2
Practice Address - City:ARROYO GRANDE
Practice Address - State:CA
Practice Address - Zip Code:93420
Practice Address - Country:US
Practice Address - Phone:805-481-8662
Practice Address - Fax:805-481-8662
Is Sole Proprietor?:No
Enumeration Date:2006-08-29
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMC0020896106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist