Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111N00000X | Chiropractor | 34576 | CA |
N | 111NP0017X | Pediatric Chiropractor | 34576 | CA |
NPI | 1922658228 |
---|---|
Provider Name | Dr. Ashley Freidel |
First Address | San Francisco, CA 94117-3330 |
Second Address | San Francisco, CA 94117-3330 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 18/09/2019 |
Last Update Date | 18/09/2019 |