Healthcare Provider Details

I. General information

NPI: 1295664845
Provider Name (Legal Business Name): BARBARA K. FREI
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/18/2026
Last Update Date: 05/18/2026
Certification Date: 05/18/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1580 E WASHINGTON ST STE 107
PETALUMA CA
94954-3600
US

IV. Provider business mailing address

112 ALTA VISTA AVE
MILL VALLEY CA
94941-1381
US

V. Phone/Fax

Practice location:
  • Phone: 707-806-4422
  • Fax:
Mailing address:
  • Phone: 628-254-4393
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171100000X
TaxonomyAcupuncturist
License NumberAC20593
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: