Provider Demographics
NPI:1801298930
Name:FRIEDEMAN, LAUREN IONE (DPT)
Entity type:Individual
Prefix:
First Name:LAUREN
Middle Name:IONE
Last Name:FRIEDEMAN
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:LAUREN
Other - Middle Name:IONE
Other - Last Name:COX
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:25 MITCHELL BLVD
Mailing Address - Street 2:SUITE 2
Mailing Address - City:SAN RAFAEL
Mailing Address - State:CA
Mailing Address - Zip Code:94903-2007
Mailing Address - Country:US
Mailing Address - Phone:415-924-5700
Mailing Address - Fax:415-924-5723
Practice Address - Street 1:25 MITCHELL BLVD
Practice Address - Street 2:SUITE 2
Practice Address - City:SAN RAFAEL
Practice Address - State:CA
Practice Address - Zip Code:94903-2007
Practice Address - Country:US
Practice Address - Phone:415-924-5700
Practice Address - Fax:415-924-5723
Is Sole Proprietor?:No
Enumeration Date:2014-09-19
Last Update Date:2014-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA41704225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist