Provider Demographics
NPI:1841030277
Name:FRIGAARD, EMILY
Entity type:Individual
Prefix:
First Name:EMILY
Middle Name:
Last Name:FRIGAARD
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:628 STONEYBROOK DR APT 297
Mailing Address - Street 2:
Mailing Address - City:CORONA
Mailing Address - State:CA
Mailing Address - Zip Code:92879-1294
Mailing Address - Country:US
Mailing Address - Phone:818-912-4781
Mailing Address - Fax:
Practice Address - Street 1:11800 CENTRAL AVE STE 225
Practice Address - Street 2:
Practice Address - City:CHINO
Practice Address - State:CA
Practice Address - Zip Code:91710-7201
Practice Address - Country:US
Practice Address - Phone:909-591-5081
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-05-31
Last Update Date:2024-05-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAPCC16684101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional