Provider Demographics
NPI:1538290564
Name:FRIEDLAND, RANDI FERN (PHD)
Entity Type:Individual
Prefix:DR
First Name:RANDI
Middle Name:FERN
Last Name:FRIEDLAND
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:345 SYCAMORE GLN
Mailing Address - Street 2:
Mailing Address - City:PASADENA
Mailing Address - State:CA
Mailing Address - Zip Code:91105-1352
Mailing Address - Country:US
Mailing Address - Phone:323-257-5882
Mailing Address - Fax:626-578-7105
Practice Address - Street 1:2810 E DEL MAR BLVD STE 1
Practice Address - Street 2:
Practice Address - City:PASADENA
Practice Address - State:CA
Practice Address - Zip Code:91107-4322
Practice Address - Country:US
Practice Address - Phone:626-356-0220
Practice Address - Fax:626-578-7105
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY8205103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist