Healthcare Provider Details

I. General information

NPI: 1356884126
Provider Name (Legal Business Name): SHERYL ANN FREEMAN CADC-LL
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: MRS. SHERYL ANN MITCHELL

II. Dates (important events)

Enumeration Date: 11/29/2016
Last Update Date: 07/17/2025
Certification Date: 07/17/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10201 MISSION GORGE RD STE O
SANTEE CA
92071-3040
US

IV. Provider business mailing address

10201 MISSION GORGE RD STE O
SANTEE CA
92071-3040
US

V. Phone/Fax

Practice location:
  • Phone: 619-383-6868
  • Fax:
Mailing address:
  • Phone: 619-383-6868
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License NumberA055441219
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code225400000X
TaxonomyRehabilitation Practitioner
License NumberA055441219
License Number StateCA
# 3
Primary TaxonomyY
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number1356884126
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: