MEDICARE: TRACI HIGGINS FREEMAN LMFT

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	106H00000X	Marriage & Family Therapist	0003079	CO
2	106H00000X	Marriage & Family Therapist	122329	CA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	0003079	OTHER	CO	LMFT
2	122329	OTHER	CA	LICENSED MARRIAGE FAMILY THERAPIST

General Provider Information

NPI Number	:	1245830280
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	TRACI HIGGINS FREEMAN LMFT

Provider Business Mailing Address
First Line	:	2024 DIVISADERO ST STE 4
Second Line	:
City	:	SAN FRANCISCO
State	:	CA
Zip	:	94115-2113
Country	:	US
Telephone Number	:	415-275-1855
Fax Number	:

Provider Business Practice Location Address
First Line	:	2024 DIVISADERO ST STE 4
Second Line	:
City	:	SAN FRANCISCO
State	:	CA
Zip	:	94115-2113
Country	:	US
Telephone Number	:	415-275-1855
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/29/2020
Last Update Date	:	03/14/2026

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