Provider Demographics
NPI:1942475983
Name:FROELICH, RYAN CHARLES (LCSW)
Entity type:Individual
Prefix:MR
First Name:RYAN
Middle Name:CHARLES
Last Name:FROELICH
Suffix:
Gender:M
Credentials:LCSW
Other - Prefix:MR
Other - First Name:RYAN
Other - Middle Name:CHARLES
Other - Last Name:FROELICH
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LCSW
Mailing Address - Street 1:405 W 5TH ST STE 202A
Mailing Address - Street 2:
Mailing Address - City:SANTA ANA
Mailing Address - State:CA
Mailing Address - Zip Code:92701-4522
Mailing Address - Country:US
Mailing Address - Phone:714-834-8344
Mailing Address - Fax:
Practice Address - Street 1:303 W LINCOLN AVE STE 130
Practice Address - Street 2:
Practice Address - City:ANAHEIM
Practice Address - State:CA
Practice Address - Zip Code:92805-2993
Practice Address - Country:US
Practice Address - Phone:714-834-3747
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-04-29
Last Update Date:2025-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALCS294621041C0700X, 1041C0700X, 104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA1942475983Medicaid