Robert Friddle

Individual provider Active NPI Addiction (Substance Use Disorder) Counselor · Bloomington, CA

NPI 1124974191 · NPPES record last updated Jun 26, 2026

Key facts

NPI
1124974191
Entity type
Individual (NPI type 1)
Primary specialty
Addiction (Substance Use Disorder) Counselor 101YA0400X
Practice address
18612 Santa Ana Ave
Bloomington, CA 92316-2639
Phone
(909) 421-7120
NPI assigned
Mar 10, 2026
Sex
Male
Sole proprietor
No

Medicare participation

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

National Provider Directory

Medicare enrollment (NPD)
No

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X CA Yes

Addresses

Primary practice location

18612 Santa Ana Ave
Bloomington, CA 92316-2639

Mailing address

18612 Santa Ana Ave
Bloomington, CA 92316-2639
Phone (909) 421-7120

Other providers in Bloomington, CA

All providers in Bloomington, CA · Addiction (Substance Use Disorder) Counselor in California

Sources for this page

Verify at the official NPI Registry.