Healthcare Provider Details

I. General information

NPI: 1275369191
Provider Name (Legal Business Name): ANGELA MARIE FREIJ DNP, FNP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/09/2024
Last Update Date: 12/18/2024
Certification Date: 12/18/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

809 S MAIN ST
SANTA ANA CA
92701-6605
US

IV. Provider business mailing address

809 S MAIN ST
SANTA ANA CA
92701-6605
US

V. Phone/Fax

Practice location:
  • Phone: 714-973-7770
  • Fax: 714-973-7775
Mailing address:
  • Phone: 714-973-7770
  • Fax: 714-973-7775

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberF08240768
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number95148856
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: