Healthcare Provider Details

I. General information

NPI: 1134248750
Provider Name (Legal Business Name): SHEILA STURGEON FREITAS PH.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: SHEILA STURGEON PH.D.

II. Dates (important events)

Enumeration Date: 03/28/2007
Last Update Date: 06/18/2026
Certification Date: 06/18/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3080 E GENTRY WAY STE 205
MERIDIAN ID
83642-3013
US

IV. Provider business mailing address

3080 E GENTRY WAY STE 205
MERIDIAN ID
83642-3013
US

V. Phone/Fax

Practice location:
  • Phone: 208-475-4690
  • Fax:
Mailing address:
  • Phone: 208-475-4690
  • Fax: 208-899-4703

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code103TC2200X
TaxonomyClinical Child & Adolescent Psychologist
License NumberPSY-202431
License Number StateID
# 2
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License NumberPSY-202431
License Number StateID
# 3
Primary TaxonomyN
Taxonomy Code103TF0000X
TaxonomyFamily Psychologist
License NumberPSY-202431
License Number StateID

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: