Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1041C0700X | Clinical Social Worker | LCS 15505 | CA |
NPI | 1003069477 |
---|---|
Provider Name | Ms. Marta Judy Friedman |
First Address | Oakland, CA 94610-1426 |
Second Address | San Rafael, CA 94903-3308 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 29/10/2008 |
Last Update Date | 29/10/2008 |