Healthcare Provider Details

I. General information

NPI: 1275620239
Provider Name (Legal Business Name): SAMANTHA FREMBGEN D.O.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/09/2006
Last Update Date: 12/13/2025
Certification Date: 12/13/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5650 E 22ND ST
TUCSON AZ
85711-5525
US

IV. Provider business mailing address

5650 E 22ND ST
TUCSON AZ
85711-5525
US

V. Phone/Fax

Practice location:
  • Phone: 520-372-8575
  • Fax: 520-372-8576
Mailing address:
  • Phone: 520-372-8575
  • Fax: 520-372-8576

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number3754
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: