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General NPI Number Information
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NPI Number | 1790433928
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Entity Type | Organization
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Legal Business Name | MIRIAM CHOR FREITAS, INC.
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Dates
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Enumeration Date | 03/16/2022
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Last Update Date | 05/07/2022
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Provider Practice Location Address
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Address Line | 12929 POMERADO RD
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City | POWAY
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State | CA
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Zip | 92064-5325
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Country | US
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Telephone | 858-842-0234
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Fax |
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Provider Business Mailing Address
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Address Line | 12915 CREEK PARK DR
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City | POWAY
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State | CA
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Zip | 92064-5762
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWNER/CLINICIAN
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Name | MIRIAM CHOR FREITAS
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Credential | LCSW
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Telephone | 858-842-0234
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number |
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License Number State |
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