Healthcare Provider Details

I. General information

NPI: 1548144587
Provider Name (Legal Business Name): FREEDOM THROUGH LIBERATION INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/04/2025
Last Update Date: 08/04/2025
Certification Date: 08/03/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

850 ROSEDALE AVE APT 30
CAPITOLA CA
95010-2237
US

IV. Provider business mailing address

850 ROSEDALE AVE APT 30
CAPITOLA CA
95010-2237
US

V. Phone/Fax

Practice location:
  • Phone: 831-920-8790
  • Fax: 831-920-8790
Mailing address:
  • Phone: 831-920-8790
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code251V00000X
TaxonomyVoluntary or Charitable Agency
License Number
License Number State

VIII. Authorized Official

Name: JENNIE NESTLER
Title or Position: CHIEF EXECUTIVE OFFICER
Credential:
Phone: 831-920-8790