Provider Demographics
NPI:1043802200
Name:FRIEDRICHSEN, PAULA JEAN
Entity Type:Individual
Prefix:
First Name:PAULA
Middle Name:JEAN
Last Name:FRIEDRICHSEN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1478 ARGYLE LN
Mailing Address - Street 2:
Mailing Address - City:BISHOP
Mailing Address - State:CA
Mailing Address - Zip Code:93514-2002
Mailing Address - Country:US
Mailing Address - Phone:760-935-4295
Mailing Address - Fax:
Practice Address - Street 1:162J GROVE ST
Practice Address - Street 2:
Practice Address - City:BISHOP
Practice Address - State:CA
Practice Address - Zip Code:93514-2640
Practice Address - Country:US
Practice Address - Phone:760-873-5888
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-02-09
Last Update Date:2021-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)