Healthcare Provider Details

I. General information

NPI: 1073382602
Provider Name (Legal Business Name): REBECCA FREY
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/22/2023
Last Update Date: 08/07/2025
Certification Date: 08/07/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4205 W FIGARDEN DR
FRESNO CA
93722-6051
US

IV. Provider business mailing address

394 RESERVATION RD APT 6
MARINA CA
93933-3227
US

V. Phone/Fax

Practice location:
  • Phone: 559-221-1680
  • Fax: 559-221-4336
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225400000X
TaxonomyRehabilitation Practitioner
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code175T00000X
TaxonomyPeer Specialist
License Number
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: