Healthcare Provider Details

I. General information

NPI: 1609705854
Provider Name (Legal Business Name): BRIA FREEMAN OTR/L
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/14/2026
Last Update Date: 05/14/2026
Certification Date: 05/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5905 SEVERIN DR
LA MESA CA
91942-3806
US

IV. Provider business mailing address

2190 SAINT CROIX CT
LEMON GROVE CA
91945-3500
US

V. Phone/Fax

Practice location:
  • Phone: 619-589-2606
  • Fax:
Mailing address:
  • Phone: 619-770-7808
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number29085
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: