Provider Demographics
NPI:1841417979
Name:FRIEDMAN, NANCY M (MA, MFT)
Entity Type:Individual
Prefix:MS
First Name:NANCY
Middle Name:M
Last Name:FRIEDMAN
Suffix:
Gender:F
Credentials:MA, MFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:631 VERNON ST
Mailing Address - Street 2:
Mailing Address - City:OAKLAND
Mailing Address - State:CA
Mailing Address - Zip Code:94610-1419
Mailing Address - Country:US
Mailing Address - Phone:510-653-1384
Mailing Address - Fax:510-653-9021
Practice Address - Street 1:631 VERNON ST
Practice Address - Street 2:
Practice Address - City:OAKLAND
Practice Address - State:CA
Practice Address - Zip Code:94610-1419
Practice Address - Country:US
Practice Address - Phone:510-653-1384
Practice Address - Fax:510-653-9021
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFT 12615106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist