Provider Demographics
NPI:1649368689
Name:FRIESEN, LAURIE LYNN (LMFT)
Entity type:Individual
Prefix:
First Name:LAURIE
Middle Name:LYNN
Last Name:FRIESEN
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 1:30200 KNIGHT CT
Mailing Address - Street 2:
Mailing Address - City:TEHACHAPI
Mailing Address - State:CA
Mailing Address - Zip Code:93561-8520
Mailing Address - Country:US
Mailing Address - Phone:661-821-2313
Mailing Address - Fax:667-821-1245
Practice Address - Street 1:20412 BRIAN WAY STE 1
Practice Address - Street 2:
Practice Address - City:TEHACHAPI
Practice Address - State:CA
Practice Address - Zip Code:93561-8702
Practice Address - Country:US
Practice Address - Phone:661-823-0661
Practice Address - Fax:661-823-8474
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFC36964101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health