Jeffrey Friedman, PHD, Psychologist, Inc

Primary specialty

PsychologistTaxonomy code 103T00000X

License

PSY9763 Issued in CA

Legal business name

JEFFREY FRIEDMAN, PHD, PSYCHOLOGIST, INC

Practice address

956 Walnut St Ste 20
San Luis Obispo, CA 93401-1707

Phone

(805) 545-9410

Fax

(805) 545-9476

NPI assigned

Aug 10, 2006

Organization subpart

No

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

Authorized official

Name

Dr. Jeffrey Steven Friedman, PH.D.NPI 1861668469

Title

President

Phone

(805) 545-9410

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Locations

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Jeffrey Steven Friedman, PH.D.

  • Psychologist
  • San Luis Obispo, CA
  • NPI 1861668469
  Medicare reassignment NPD Authorized official
• Matthew Kilthau, M.D.

  • Psychiatry Physician
  • San Luis Obispo, CA
  • NPI 1831456151
  NPD
• Nell Bennett, LCSW

  • Clinical Social Worker
  • San Luis Obispo, CA
  • NPI 1326419425
  NPD (past)

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

{
    "created_epoch": "1155168000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1552521600000",
    "number": "1659382182",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1015 NIPOMO ST",
            "address_2": "STE 230",
            "city": "SAN LUIS OBISPO",
            "state": "CA",
            "postal_code": "934013874",
            "telephone_number": "805-545-9410",
            "fax_number": "805-545-9476"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "956 WALNUT ST STE 20",
            "city": "SAN LUIS OBISPO",
            "state": "CA",
            "postal_code": "934011707",
            "telephone_number": "805-545-9410",
            "fax_number": "805-545-9476"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JEFFREY FRIEDMAN, PHD, PSYCHOLOGIST, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-10",
        "last_updated": "2019-03-14",
        "status": "A",
        "authorized_official_last_name": "FRIEDMAN",
        "authorized_official_first_name": "JEFFREY",
        "authorized_official_middle_name": "STEVEN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "805-545-9410",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PH.D."
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychologist",
            "state": "CA",
            "license": "PSY9763",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ellen Darling Jaworski
• Jean Yu
• Vanessa Breann Jeffers, M.ED., BCBA
• Patrick John Jeffery
• Jeffrey B Mundorf, MD, Inc.
• Jeffrey M. Bloom M.D. Inc
• David Allen Jeffrey, OTR
• Curby Dirk Jenkins, DO
• Melissa Jenkins
• Griffith Jennings

• Psychologist in San Luis Obispo, CA
• Providers in San Luis Obispo, CA by specialty
• Psychologist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 14, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.