Individual
FREDA FELICIA FORREST
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
760 MOUNTAIN VIEW ST, ALTADENA, CA 91001-4996
(862) 679-8679
Mailing address
760 MOUNTAIN VIEW ST, ALTADENA, CA 91001-4996
(862) 679-8679
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
—
—
172V00000X
Community Health Worker
Primary
—
—
225400000X
Rehabilitation Practitioner
—
—
Other
Enumeration date
12/19/2017
Last updated
06/06/2023
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