Individual
JENNIFER FREEMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
3883 AIRWAY DR STE 203, SANTA ROSA, CA 95403-1671
(707) 521-7760
(707) 521-7759
Mailing address
325 DISTEL CIR, LOS ALTOS, CA 94022-1408
(707) 521-7760
(707) 521-7759
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
A153193
CA
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
A153193
STATE MEDICAL LICENSE
CA
Enumeration date
03/25/2016
Last updated
11/09/2020
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