Provider Demographics
NPI:1053712729
Name:FRIEDMAN, CARRIE ELIZABETH WILSON (RN,MSN, FNP)
Entity type:Individual
Prefix:
First Name:CARRIE
Middle Name:ELIZABETH WILSON
Last Name:FRIEDMAN
Suffix:
Gender:F
Credentials:RN,MSN, FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16055 VENTURA BLVD
Mailing Address - Street 2:SUITE 712
Mailing Address - City:ENCINO
Mailing Address - State:CA
Mailing Address - Zip Code:91436-2601
Mailing Address - Country:US
Mailing Address - Phone:818-386-1395
Mailing Address - Fax:888-882-6061
Practice Address - Street 1:16055 VENTURA BLVD
Practice Address - Street 2:SUITE 712
Practice Address - City:ENCINO
Practice Address - State:CA
Practice Address - Zip Code:91436-2601
Practice Address - Country:US
Practice Address - Phone:818-386-1395
Practice Address - Fax:888-882-6061
Is Sole Proprietor?:No
Enumeration Date:2014-09-11
Last Update Date:2023-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95001868363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health