Active NPI
James Gordon Friesen
- Clinical Psychologist
- Porter Ranch, CA
National Provider Identifier
1548494354
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- PSY7018
- Practice address
- 11145 Tampa Ave
Suite 23a
Porter Ranch, CA 91326 - Phone
- (818) 893-4463
- NPI assigned
- May 7, 2009
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | PSY7018 | CA | Primary |
Addresses
Primary practice location
11145 Tampa Ave
Suite 23a
Porter Ranch, CA 91326
Mailing address
9018 Balboa BL.
#538
Northridge, CA 91325
Phone (818) 893-4463
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 00PL70180 | Other | CA | BLUE SHIELD PIN # |
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PSY7018 | CA | MD | Clinical Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1241654400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1241654400000",
"number": "1548494354",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "9018 BALBOA BL.",
"address_2": "#538",
"city": "NORTHRIDGE",
"state": "CA",
"postal_code": "91325",
"telephone_number": "818-893-4463"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "11145 TAMPA AVE",
"address_2": "SUITE 23A",
"city": "PORTER RANCH",
"state": "CA",
"postal_code": "91326",
"telephone_number": "818-893-4463"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FRIESEN",
"first_name": "JAMES",
"middle_name": "GORDON",
"name_prefix": "Dr.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2009-05-07",
"last_updated": "2009-05-07",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "CA",
"license": "PSY7018",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE SHIELD PIN #",
"identifier": "00PL70180",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Porter Ranch, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 7, 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.