Provider Demographics
NPI:1760679344
Name:FRIEDBERG, GENEVIEVE ELIZABETH (MA)
Entity Type:Individual
Prefix:
First Name:GENEVIEVE
Middle Name:ELIZABETH
Last Name:FRIEDBERG
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:904 ROSEDALE AVE APT A
Mailing Address - Street 2:
Mailing Address - City:CAPITOLA
Mailing Address - State:CA
Mailing Address - Zip Code:95010-3636
Mailing Address - Country:US
Mailing Address - Phone:831-454-6362
Mailing Address - Fax:
Practice Address - Street 1:555 SOQUEL AVE STE 320
Practice Address - Street 2:
Practice Address - City:SANTA CRUZ
Practice Address - State:CA
Practice Address - Zip Code:95062-2342
Practice Address - Country:US
Practice Address - Phone:831-454-6362
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-09-27
Last Update Date:2018-05-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health