Provider Demographics
NPI:1760491021
Name:CUNNINGHAM, FRIEDEL BARBARA (AUD)
Entity Type:Individual
Prefix:DR
First Name:FRIEDEL
Middle Name:BARBARA
Last Name:CUNNINGHAM
Suffix:
Gender:F
Credentials:AUD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17231 KNAPP ST
Mailing Address - Street 2:
Mailing Address - City:NORTHRIDGE
Mailing Address - State:CA
Mailing Address - Zip Code:91325-2549
Mailing Address - Country:US
Mailing Address - Phone:818-341-5407
Mailing Address - Fax:818-341-4105
Practice Address - Street 1:18401 BURBANK BLVD STE 106
Practice Address - Street 2:
Practice Address - City:TARZANA
Practice Address - State:CA
Practice Address - Zip Code:91356-2871
Practice Address - Country:US
Practice Address - Phone:818-341-5407
Practice Address - Fax:818-341-4105
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAU1539/HA3352237600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237600000XSpeech, Language and Hearing Service ProvidersAudiologist-Hearing Aid Fitter
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAAU0015390Medicaid
CAAU0015390Medicaid