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NPI Code Detail

MEDICARE: GLORIA A CERVANTES-FREEMAN ACSW

MEDICARE: GLORIA A CERVANTES-FREEMAN ACSW
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1172V00000XCommunity Health Worker
21041C0700XClinical Social WorkerASW133214CA
3390200000XStudent in an Organized Health Care Education/Training Program
4106S00000XBehavior Technician

General Provider Information

NPI Number : 1043789993
Entity Type Code : Individual
Provider Name (Legal Business Name) : GLORIA A CERVANTES-FREEMAN ACSW
Provider Business Mailing Address
First Line : 300 S HARBOR BLVD STE 910
Second Line :
City : ANAHEIM
State : CA
Zip : 92805-3721
Country : US
Telephone Number : 562-821-1491
Fax Number :
Provider Business Practice Location Address
First Line : 300 S HARBOR BLVD STE 910
Second Line :
City : ANAHEIM
State : CA
Zip : 92805-3721
Country : US
Telephone Number : 562-821-1491
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/21/2018
Last Update Date : 09/18/2025

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