MEDICARE: JACQUELINE FREYRE

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
1	103TS0200X	School Psychologist	4036	CA

General Provider Information

NPI Number	:	1831057900
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JACQUELINE FREYRE

Provider Business Mailing Address
First Line	:	11200 TELECHRON AVE
Second Line	:
City	:	WHITTIER
State	:	CA
Zip	:	90605-3729
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	192 PARK AVE
Second Line	:
City	:	LONG BEACH
State	:	CA
Zip	:	90803-3153
Country	:	US
Telephone Number	:	562-380-2708
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/15/2026
Last Update Date	:	01/15/2026

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Directions to “ JACQUELINE FREYRE ” Practice Location

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