Healthcare Provider Details

I. General information

NPI: 1285408443
Provider Name (Legal Business Name): ELISE FREUND DC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/08/2023
Last Update Date: 06/10/2026
Certification Date: 06/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

712 D ST STE E
SAN RAFAEL CA
94901-3706
US

IV. Provider business mailing address

712 D ST STE E
SAN RAFAEL CA
94901-3706
US

V. Phone/Fax

Practice location:
  • Phone: 415-909-3299
  • Fax:
Mailing address:
  • Phone: 415-909-3299
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number36771
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: