Provider Demographics
NPI:1649550922
Name:FRYDMAN, DAHLIA A (IBCLC, MASTER DOULA)
Entity type:Individual
Prefix:
First Name:DAHLIA
Middle Name:A
Last Name:FRYDMAN
Suffix:
Gender:F
Credentials:IBCLC, MASTER DOULA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7454 VISTA DEL MONTE
Mailing Address - Street 2:
Mailing Address - City:VAN NUYS
Mailing Address - State:CA
Mailing Address - Zip Code:91405
Mailing Address - Country:US
Mailing Address - Phone:818-786-1877
Mailing Address - Fax:
Practice Address - Street 1:7454 VISTA DEL MONTE
Practice Address - Street 2:
Practice Address - City:VAN NUYS
Practice Address - State:CA
Practice Address - Zip Code:91405
Practice Address - Country:US
Practice Address - Phone:818-786-1877
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-08-18
Last Update Date:2011-11-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA374J00000X
VA11159940174N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174N00000XOther Service ProvidersLactation Consultant, Non-RN
No374J00000XNursing Service Related ProvidersDoula
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA374J00000XOtherNURSING SERVICES, RELATED PROVIDER
CA11159940OtherIBCLC