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NPI Code Detail

MEDICARE: MRS. FANNY JUDITH FRAIM

MEDICARE: MRS. FANNY JUDITH FRAIM
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
1175T00000XPeer Specialist
2171M00000XCase Manager/Care CoordinatorCA

General Provider Information

NPI Number : 1093937823
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. FANNY JUDITH FRAIM
Provider Business Mailing Address
First Line : 1029 N BROADWAY
Second Line :
City : ESCONDIDO
State : CA
Zip : 92026-3043
Country : US
Telephone Number : 760-489-2146
Fax Number : 760-489-4129
Provider Business Practice Location Address
First Line : 1029 N BROADWAY
Second Line :
City : ESCONDIDO
State : CA
Zip : 92026-3043
Country : US
Telephone Number : 760-489-4126
Fax Number : 760-489-4129
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/02/2007
Last Update Date : 05/31/2023

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Directions to “ MRS. FANNY JUDITH FRAIM ” Practice Location

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