Provider Demographics
NPI:1750469425
Name:FRIEND, DANICE J (PHD)
Entity Type:Individual
Prefix:DR
First Name:DANICE
Middle Name:J
Last Name:FRIEND
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 1:1315 CLARKE ST
Mailing Address - Street 2:SUITE C
Mailing Address - City:SAN LEANDRO
Mailing Address - State:CA
Mailing Address - Zip Code:94577
Mailing Address - Country:US
Mailing Address - Phone:510-351-1257
Mailing Address - Fax:510-351-1257
Practice Address - Street 1:1315 CLARKE ST
Practice Address - Street 2:SUITE C
Practice Address - City:SAN LEANDRO
Practice Address - State:CA
Practice Address - Zip Code:94577-3632
Practice Address - Country:US
Practice Address - Phone:510-351-1257
Practice Address - Fax:510-351-1257
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA18810103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist