Individual provider Active NPI

Marta Judy Friedman, LCSW, JD

  • Clinical Social Worker
  • San Rafael, CA
National Provider Identifier
1003069477
Registry record updated Oct 29, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
LCS 15505 Issued in CA
Practice address
99 Montecillo Rd
San Rafael, CA 94903-3308
Phone
(415) 444-4396
NPI assigned
Oct 29, 2008
Last updated
Oct 29, 2008By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 29, 2008

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X LCS 15505 CA Primary

Addresses

Primary practice location

99 Montecillo Rd
San Rafael, CA 94903-3308

Mailing address

558 Vernon St
Oakland, CA 94610-1426
Phone (510) 655-0650

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Juris Doctor

State licenses

LicenseStateTypeSpecialty
LCS 15505CAMDClinical Social Worker

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1225238400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1225238400000",
    "number": "1003069477",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "558 VERNON ST",
            "city": "OAKLAND",
            "state": "CA",
            "postal_code": "946101426",
            "telephone_number": "510-655-0650"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "99 MONTECILLO RD",
            "city": "SAN RAFAEL",
            "state": "CA",
            "postal_code": "949033308",
            "telephone_number": "415-444-4396"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FRIEDMAN",
        "first_name": "MARTA",
        "middle_name": "JUDY",
        "name_prefix": "Ms.",
        "credential": "LCSW, JD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-10-29",
        "last_updated": "2008-10-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "LCS 15505",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Rafael, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 29, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.