Theodore E Friedman, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

70492 Issued in CA

Practice address

5575 Lake Park Way
Suite 100 Unit 1
La Mesa, CA 91942-1664

Phone

(619) 729-8547

Fax

(619) 881-0088

NPI assigned

Aug 16, 2011

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Clinical Social Worker

Education

Other, 2012

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1313452800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1456444800000",
    "number": "1497034805",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7136 MURRAY PARK DR",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921192938",
            "telephone_number": "619-729-8547",
            "fax_number": "619-881-0088"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5575 LAKE PARK WAY",
            "address_2": "SUITE 100 UNIT 1",
            "city": "LA MESA",
            "state": "CA",
            "postal_code": "919421664",
            "telephone_number": "619-729-8547",
            "fax_number": "619-881-0088"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FRIEDMAN",
        "first_name": "THEODORE",
        "middle_name": "E",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2011-08-16",
        "last_updated": "2016-02-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "70492",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Bria Freeman, OTR/L
• Hannah Freeman, MA, APCC
• Labrie S French-Asaro, MFT
• Fresenius Medical Care Balboa II, LLC (Fresenius Medical Care Balboa la Mesa)
• William Eugene Friedel, M.D.
• Yangheng Fu, M.D.
• Ana Fuentes Calderon
• Rhea W Fugal, L.C.S.W.
• Kevin L. Fulford, MD
• Gary R. Funk, O.D.

• Clinical Social Worker in La Mesa, CA
• Providers in La Mesa, CA by specialty
• Clinical Social Worker in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 26, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.