Healthcare Provider Details

I. General information

NPI: 1952192536
Provider Name (Legal Business Name): ANTHONY JOSEPH FREITAS PTA
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/14/2025
Last Update Date: 05/14/2025
Certification Date: 05/14/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2125 N OLIVE AVE
TURLOCK CA
95382-1947
US

IV. Provider business mailing address

10133 SHERRILL BLVD STE 200
KNOXVILLE TN
37932-3347
US

V. Phone/Fax

Practice location:
  • Phone: 209-585-3805
  • Fax:
Mailing address:
  • Phone: 888-531-2204
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225200000X
TaxonomyPhysical Therapy Assistant
License Number10368
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: