Provider Demographics
NPI:1649394602
Name:FRIEDMAN, SONYA MAY (PHD, MFT)
Entity Type:Individual
Prefix:
First Name:SONYA
Middle Name:MAY
Last Name:FRIEDMAN
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:PO BOX 1157
Mailing Address - Street 2:
Mailing Address - City:FERNDALE
Mailing Address - State:CA
Mailing Address - Zip Code:95536-1157
Mailing Address - Country:US
Mailing Address - Phone:707-786-9822
Mailing Address - Fax:707-786-9842
Practice Address - Street 1:1071 MAIN ST
Practice Address - Street 2:
Practice Address - City:FERNDALE
Practice Address - State:CA
Practice Address - Zip Code:95536-1157
Practice Address - Country:US
Practice Address - Phone:707-786-9822
Practice Address - Fax:707-786-9842
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFT16524101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAZZZ19807ZOtherBLUE SHIELD