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NPI Code Detail

MEDICARE: MRS. JENNA LYNN FREEMAN

MEDICARE: MRS. JENNA LYNN FREEMAN
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
1101YM0800XMental Health Counselor

General Provider Information

NPI Number : 1508885179
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. JENNA LYNN FREEMAN
Provider Business Mailing Address
First Line : 8211 SAN ANGELO DR
Second Line : G14
City : HUNTINGTON BEACH
State : CA
Zip : 92647-9217
Country : US
Telephone Number : 714-331-7356
Fax Number :
Provider Business Practice Location Address
First Line : 1615 FRENCH ST
Second Line : SUITE 209
City : SANTA ANA
State : CA
Zip : 92701-2475
Country : US
Telephone Number : 714-824-8140
Fax Number : 714-824-8141
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/18/2006
Last Update Date : 07/31/2009

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Directions to “ MRS. JENNA LYNN FREEMAN ” Practice Location

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