Provider Demographics
NPI:1912132465
Name:FRIEDMAN, DAVID WASLEY (PSYD)
Entity Type:Individual
Prefix:DR
First Name:DAVID
Middle Name:WASLEY
Last Name:FRIEDMAN
Suffix:
Gender:M
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:921 THE ALAMEDA
Mailing Address - Street 2:
Mailing Address - City:BERKELEY
Mailing Address - State:CA
Mailing Address - Zip Code:94707-2311
Mailing Address - Country:US
Mailing Address - Phone:510-868-2250
Mailing Address - Fax:
Practice Address - Street 1:921 THE ALAMEDA
Practice Address - Street 2:
Practice Address - City:BERKELEY
Practice Address - State:CA
Practice Address - Zip Code:94707-2311
Practice Address - Country:US
Practice Address - Phone:510-868-2250
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-05-27
Last Update Date:2015-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY27050103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical