Provider Demographics
NPI:1396998167
Name:FROEHLICH, JUDITH LIBBY (LMFT)
Entity type:Individual
Prefix:
First Name:JUDITH
Middle Name:LIBBY
Last Name:FROEHLICH
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 373
Mailing Address - Street 2:
Mailing Address - City:JAMUL
Mailing Address - State:CA
Mailing Address - Zip Code:91935-0373
Mailing Address - Country:US
Mailing Address - Phone:619-249-4148
Mailing Address - Fax:
Practice Address - Street 1:2423 CAMINO DEL RIO S
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92108-3702
Practice Address - Country:US
Practice Address - Phone:619-249-4148
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-10-24
Last Update Date:2011-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA44483106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist