MICHAEL FRESE (NPI# 1588975247) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1588975247 |
| Entity Type | Individual |
| Full Name | MICHAEL FRESE |
| Credential | PH.D. |
| Practice Address |
11911 San Vicente Blvd Ste 280 Los Angeles CA 90049-6611 |
| Mailing Address |
Po Box 491665 Los Angeles CA 90049-8665 |
| Practice Telephone | 8188511051 |
| Mailing Telephone | 8188511051 |
| Enumeration Date | 2010-06-28 |
| Last Update Date | 2018-10-18 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 103TA0700X |
Psychologist Specialization: Adult Development & Aging |
PSY23493 | CA | Behavioral Health & Social Service Providers |
| N | 103TB0200X |
Psychologist Specialization: Cognitive & Behavioral |
PSY23493 | CA | Behavioral Health & Social Service Providers |
| Y | 103TC0700X |
Psychologist Specialization: Clinical |
PSY23493 | CA | Behavioral Health & Social Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CA | BOARD OF PSYCHOLOGY | PSY23493 | 01 |
| Street Address |
11911 SAN VICENTE BLVD STE 280 |
| City | LOS ANGELES |
| State | CA |
| Zip Code | 90049-6611 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1245490499 | Andrea Von Troschke | Marriage & Family Therapist | 11911 San Vicente Blvd Ste 280, Los Angeles, CA 90049-6611 | 2008-06-11 |
| 1881087286 | Michelle Asten | Social Worker | 11911 San Vicente Blvd Ste 280, Los Angeles, CA 90049-6611 | 2015-03-09 |
| 1508095795 | Eunice Kim | Psychologist | 11911 San Vicente Blvd Ste 280, Los Angeles, CA 90049-6611 | 2009-07-08 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1316564339 | Kepp Family & Group Practice | Marriage & Family Therapist | 12011 San Vincente Blvd, 408, Los Angeles, CA 90049 | 2020-06-26 |
| 1386204493 | Steven J Lehrman | Marriage & Family Therapist | 179 S. Barrington Place, Office A, Los Angeles, CA 90049 | 2019-06-20 |
| 1922562990 | Jand. Inc. | Eyewear Supplier (Equipment, not the service) | 860 S. Sepulveda Blvd., Los Angeles, CA 90049 | 2019-01-24 |
| 1851864946 | Christie Schnur | Marriage & Family Therapist | 11911 San Vicente Blvd., Los Angeles, CA 90049 | 2019-01-10 |
| 1669954012 | Barbara Jiji Schenk | Marriage & Family Therapist | 520 S. Sepulveda Blvd #402, Los Angeles, CA 90049 | 2018-09-02 |
| 1972090710 | Community Reflections Inc | Counselor | 10020 So. Western Ave, 10020 So. Western Ave, Los Angeles, CA 90049 | 2018-04-17 |
| 1245738830 | Dr. Shirin Tabib LLC | Marriage & Family Therapist | 61133 San Vincent Blvd, Suite 318 A, Los Angeles, CA 90049 | 2018-01-29 |
| 1295240679 | Robert A Brooks | Preventive Medicine | 149 South Barrington Ave, #346, Los Angeles, CA 90049 | 2017-12-07 |
| 1598286478 | Marvin S Serrano | Physical Therapy Assistant | 11740 San Vicente Boulevard Suite 205, Los Angeles, CA 90049 | 2017-06-30 |
| 1972055812 | Evolve Growth Initiatives, LLC | Psychiatric Residential Treatment Facility | 820 Moraga Drive, Los Angeles, CA 90049 | 2016-10-26 |
| Find all providers in zip 90049 | ||||
| Taxonomy Code | 103TC0700X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Psychologist |
| Specialization | Clinical |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1558962324 | Marjan-marcia Khalitchi-alavi | Psychologist | 12400 Wilshire Blvd #230, Los Angeles, CA 90025 | 2020-11-06 |
| 1851990626 | Sarah R Martin | Psychologist | 650 Charles E Young Dr S # 12-096, Los Angeles, CA 90095-8347 | 2020-10-22 |
| 1184223851 | Emily Jenchura | Psychologist | 11301 Wilshire Blvd (116b, Rm. A-130), Los Angeles, CA 90073 | 2020-10-22 |
| 1679189377 | Dr. Sandra Jeanne Brim, Ph.d. | Psychologist | 11601 Gorham Ave Apt 1, Los Angeles, CA 90049-4738 | 2020-09-17 |
| 1194330274 | Marilyn S Zweifach | Psychologist | 3606 Barry Avenue, Los Angeles, CA 90066 | 2020-09-15 |
| 1538787874 | Molly Burrets | Psychologist | 5619 N Figueroa St Apt 219, Los Angeles, CA 90042-4979 | 2020-07-13 |
| 1770100737 | Mary Carde | Psychologist | 1572 Ensley Ave, Los Angeles, CA 90024-5325 | 2020-06-25 |
| 1134745193 | Bloom Psychology, Inc. | Psychologist | 3800 Barham Blvd Ste 420, Los Angeles, CA 90068-1042 | 2020-06-24 |
| 1639799406 | Joseph Aguayo | Psychologist | 11849 W Olympic Blvd Ste 202, Los Angeles, CA 90064-1148 | 2020-04-22 |
| 1912536020 | Butterflly Health, Inc. | Psychologist | 3530 Wilshire Blvd Ste 1650, Los Angeles, CA 90010-2371 | 2020-04-02 |
| Find all providers in LOS ANGELES | ||||
| City | LOS ANGELES |
| Zip Code | 90049 |
Please comment or provide details below to improve the information on MICHAEL FRESE.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.