Provider Demographics
NPI:1285628503
Name:FRISCH, PATRICIA (PHD, MFT)
Entity Type:Individual
Prefix:
First Name:PATRICIA
Middle Name:
Last Name:FRISCH
Suffix:
Gender:F
Credentials:PHD, MFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:315 ELDRIDGE AVE
Mailing Address - Street 2:
Mailing Address - City:MILL VALLEY
Mailing Address - State:CA
Mailing Address - Zip Code:94941-1046
Mailing Address - Country:US
Mailing Address - Phone:415-388-0622
Mailing Address - Fax:415-381-0196
Practice Address - Street 1:315 ELDRIDGE AVE
Practice Address - Street 2:
Practice Address - City:MILL VALLEY
Practice Address - State:CA
Practice Address - Zip Code:94941-1046
Practice Address - Country:US
Practice Address - Phone:415-388-0622
Practice Address - Fax:415-381-0196
Is Sole Proprietor?:Yes
Enumeration Date:2005-08-31
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY8206103T00000X
CAMFC8298106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered103T00000XBehavioral Health & Social Service ProvidersPsychologist
Not Answered106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist