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NPI Code Detail

MEDICARE: JASON SEAN FREMAN

MEDICARE: JASON SEAN FREMAN
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
1163W00000XRegistered Nurse680564CA

General Provider Information

NPI Number : 1366310039
Entity Type Code : Individual
Provider Name (Legal Business Name) : JASON SEAN FREMAN
Provider Business Mailing Address
First Line : 4865 BRIDLE TRL
Second Line :
City : SANTA ROSA
State : CA
Zip : 95409-4206
Country : US
Telephone Number : 707-328-1033
Fax Number : 707-328-1033
Provider Business Practice Location Address
First Line : 4865 BRIDLE TRL
Second Line :
City : SANTA ROSA
State : CA
Zip : 95409-4206
Country : US
Telephone Number : 707-328-1033
Fax Number : 707-328-1033
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/25/2025
Last Update Date : 10/25/2025

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