Healthcare Provider Details

I. General information

NPI: 1477022382
Provider Name (Legal Business Name): JESSICA N. FREEMAN M.A.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/20/2018
Last Update Date: 01/08/2026
Certification Date: 01/08/2026
Deactivation Date: 01/30/2019
Reactivation Date: 12/10/2025

III. Provider practice location address

520 E TULARE AVE
VISALIA CA
93292-3629
US

IV. Provider business mailing address

520 E TULARE AVE
VISALIA CA
93292-3629
US

V. Phone/Fax

Practice location:
  • Phone: 559-623-0900
  • Fax:
Mailing address:
  • Phone: 559-623-0900
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363AM0700X
TaxonomyMedical Physician Assistant
License Number
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: