Provider Demographics
NPI:1376087114
Name:FRIEDMAN, LORI BETH (NP)
Entity Type:Individual
Prefix:MS
First Name:LORI
Middle Name:BETH
Last Name:FRIEDMAN
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6017 ALEXANDRA CT
Mailing Address - Street 2:
Mailing Address - City:OAK PARK
Mailing Address - State:CA
Mailing Address - Zip Code:91377-5833
Mailing Address - Country:US
Mailing Address - Phone:818-917-1783
Mailing Address - Fax:
Practice Address - Street 1:6017 ALEXANDRA CT
Practice Address - Street 2:
Practice Address - City:OAK PARK
Practice Address - State:CA
Practice Address - Zip Code:91377-5833
Practice Address - Country:US
Practice Address - Phone:818-917-1783
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-12-13
Last Update Date:2016-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA831435363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily