Basic Information
Provider Information
NPI: 1861544215
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: FRIEDMAN
FirstName: JOANNA
MiddleName: GRABAREK
NamePrefix: DR.
NameSuffix:  
Credential: PH.D.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 1425 S MAIN ST
Address2: DEPARTMENT OF MENTAL HEALTH
City: WALNUT CREEK
State: CA
PostalCode: 945965318
CountryCode: US
TelephoneNumber: 9252954932
FaxNumber: 9252956140
Practice Location
Address1: 710 S BROADWAY
Address2: SUITE 205
City: WALNUT CREEK
State: CA
PostalCode: 945965294
CountryCode: US
TelephoneNumber: 9252954932
FaxNumber: 9252956140
Other Information
ProviderEnumerationDate: 01/17/2007
LastUpdateDate: 01/03/2022
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
103TC0700XPSY20564CAY Behavioral Health & Social Service ProvidersPsychologistClinical

No ID Information.


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