Active NPI
Gillian Stephany Friedman, MD
- Psychiatry Physician
- San Bernandino, CA
National Provider Identifier
1336282052
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychiatry Physician
- License
- A77158
- Practice address
- 2080 S. E Street
San Bernandino, CA 92408 - Phone
- (909) 388-9191
- Fax
- (909) 388-9195
- NPI assigned
- Feb 14, 2007
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychiatry Physician | 2084P0800X | A77158 | CA | Primary |
Addresses
Primary practice location
2080 S. E Street
San Bernandino, CA 92408
Mailing address
2701 Harbor Blvd
Ste E2-17
Costa Mesa, CA 92626
Phone (310) 955-1805
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 00A771580 | Medicaid | CA |
Other names 1
- Ms. Gillian Stephany Herald
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)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| A77158 | CA | MD | Psychiatry Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Telecare Corporation | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Health Maintenance Organization
- San Bernardino, CA
- NPI 1770741282
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1171411200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1245283200000",
"number": "1336282052",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2701 HARBOR BLVD",
"address_2": "STE E2-17",
"city": "COSTA MESA",
"state": "CA",
"postal_code": "92626",
"telephone_number": "310-955-1805",
"fax_number": "914-966-1494"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2080 S. E STREET",
"city": "SAN BERNANDINO",
"state": "CA",
"postal_code": "92408",
"telephone_number": "909-388-9191",
"fax_number": "909-388-9195"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FRIEDMAN",
"first_name": "GILLIAN",
"middle_name": "STEPHANY",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-02-14",
"last_updated": "2009-06-18",
"status": "A"
},
"taxonomies": [
{
"code": "2084P0800X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Psychiatry",
"state": "CA",
"license": "A77158",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "00A771580",
"state": "CA"
}
],
"endpoints": [],
"other_names": [
{
"first_name": "GILLIAN",
"last_name": "HERALD",
"middle_name": "STEPHANY",
"prefix": "MS.",
"code": "1",
"type": "Former Name"
}
]
}Other providers in San Bernandino, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 18, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.