Provider Demographics
NPI:1356541718
Name:FREY, EDWARD GRIFFITH (PHD)
Entity type:Individual
Prefix:DR
First Name:EDWARD
Middle Name:GRIFFITH
Last Name:FREY
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8502 E CHAPMAN AVE # 265
Mailing Address - Street 2:
Mailing Address - City:ORANGE
Mailing Address - State:CA
Mailing Address - Zip Code:92869-2461
Mailing Address - Country:US
Mailing Address - Phone:714-288-2824
Mailing Address - Fax:714-288-2824
Practice Address - Street 1:8502 E CHAPMAN AVE # 265
Practice Address - Street 2:
Practice Address - City:ORANGE
Practice Address - State:CA
Practice Address - Zip Code:92869-2461
Practice Address - Country:US
Practice Address - Phone:714-288-2824
Practice Address - Fax:714-288-2824
Is Sole Proprietor?:Yes
Enumeration Date:2007-07-23
Last Update Date:2007-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY 8204103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist