Individual
MR. FREEBORN IDJADJA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
9130 NOLAN ST APT 281, ELK GROVE, CA 95758-7539
(916) 267-5091
Mailing address
2150 STOCKTON BLVD, SACRAMENTO, CA 95817-1337
(916) 267-5091
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
—
—
172V00000X
Community Health Worker
Primary
—
—
Other
Enumeration date
07/05/2022
Last updated
08/29/2024
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