Provider Demographics
NPI:1871786475
Name:FRIED, RACHEL (MA)
Entity type:Individual
Prefix:MRS
First Name:RACHEL
Middle Name:
Last Name:FRIED
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4201 LONG BEACH BLVD
Mailing Address - Street 2:406
Mailing Address - City:LONG BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:90807-2007
Mailing Address - Country:US
Mailing Address - Phone:180-062-4147
Mailing Address - Fax:
Practice Address - Street 1:4201 LONG BEACH BLVD
Practice Address - Street 2:406
Practice Address - City:LONG BEACH
Practice Address - State:CA
Practice Address - Zip Code:90807-2007
Practice Address - Country:US
Practice Address - Phone:180-062-4147
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-08-27
Last Update Date:2016-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist