Provider Demographics
NPI:1588719090
Name:FRIEDMAN, JODY (LCSW)
Entity type:Individual
Prefix:
First Name:JODY
Middle Name:
Last Name:FRIEDMAN
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:995 POTRERO AVE
Mailing Address - Street 2:SFGH/CASARC WARD 82
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94110-2859
Mailing Address - Country:US
Mailing Address - Phone:415-206-6271
Mailing Address - Fax:415-206-6273
Practice Address - Street 1:995 POTRERO AVE
Practice Address - Street 2:SFGH/CASARC WARD 82
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94110-2859
Practice Address - Country:US
Practice Address - Phone:415-206-6271
Practice Address - Fax:416-206-6273
Is Sole Proprietor?:No
Enumeration Date:2007-01-24
Last Update Date:2010-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA185371041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical