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NPI Code Detail

MEDICARE: FREDA FELICIA FORREST

MEDICARE: FREDA FELICIA FORREST
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
1171M00000XCase Manager/Care Coordinator
2225400000XRehabilitation Practitioner
3172V00000XCommunity Health Worker

General Provider Information

NPI Number : 1487160974
Entity Type Code : Individual
Provider Name (Legal Business Name) : FREDA FELICIA FORREST
Provider Business Mailing Address
First Line : 760 MOUNTAIN VIEW ST
Second Line :
City : ALTADENA
State : CA
Zip : 91001-4996
Country : US
Telephone Number : 862-679-8679
Fax Number :
Provider Business Practice Location Address
First Line : 760 MOUNTAIN VIEW ST
Second Line :
City : ALTADENA
State : CA
Zip : 91001-4996
Country : US
Telephone Number : 862-679-8679
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/19/2017
Last Update Date : 06/06/2023

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Directions to “ FREDA FELICIA FORREST ” Practice Location

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These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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