Provider Demographics
NPI:1174789572
Name:FRIEDRICH, MARTINA C (MFT)
Entity type:Individual
Prefix:MISS
First Name:MARTINA
Middle Name:C
Last Name:FRIEDRICH
Suffix:
Gender:F
Credentials:MFT
Other - Prefix:MISS
Other - First Name:MARTINA
Other - Middle Name:C
Other - Last Name:LEE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MFT
Mailing Address - Street 1:26250 INDUSTRIAL BLVD STE 45
Mailing Address - Street 2:
Mailing Address - City:HAYWARD
Mailing Address - State:CA
Mailing Address - Zip Code:94545-2922
Mailing Address - Country:US
Mailing Address - Phone:415-225-6290
Mailing Address - Fax:
Practice Address - Street 1:22248 MAIN ST
Practice Address - Street 2:
Practice Address - City:HAYWARD
Practice Address - State:CA
Practice Address - Zip Code:94541-4005
Practice Address - Country:US
Practice Address - Phone:415-225-6290
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-08-05
Last Update Date:2024-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101YA0400X
CAIMF 59198106H00000X
CALMFT 83243106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)