1639727233 NPI number — KATHLEEN KAYLEE FRIEDMAN PHD, LPC, NCC

Table of content: KATHLEEN KAYLEE FRIEDMAN PHD, LPC, NCC (NPI 1639727233)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1639727233 NPI number — KATHLEEN KAYLEE FRIEDMAN PHD, LPC, NCC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
FRIEDMAN
Provider First Name:
KATHLEEN
Provider Middle Name:
KAYLEE
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
PHD, LPC, NCC
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
FRIEDMAN
Provider Other First Name:
KAYLEE
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
PHD, LPC
Provider Other Last Name Type Code:
5

NPI Number Information

NPI Number:
1639727233
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
08/20/2026
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
3133 SCOTTYS TER
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
SIMI VALLEY
Provider Business Mailing Address State Name:
CA
Provider Business Mailing Address Postal Code:
93063-1010
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
360 NASSAU ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
PRINCETON
Provider Business Practice Location Address State Name:
NJ
Provider Business Practice Location Address Postal Code:
08540-4646
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
609-436-0375
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
08/28/2019

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 101YM0800X , with the licence number:  37AC00490800 , registered in the state of NJ ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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