Provider Demographics
NPI:1033461843
Name:FREEMAN, LYNN (MFT)
Entity Type:Individual
Prefix:
First Name:LYNN
Middle Name:
Last Name:FREEMAN
Suffix:
Gender:F
Credentials:MFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1399 YGNACIO VALLEY RD
Mailing Address - Street 2:SUITE 12
Mailing Address - City:WALNUT CREEK
Mailing Address - State:CA
Mailing Address - Zip Code:94598-2884
Mailing Address - Country:US
Mailing Address - Phone:925-330-3279
Mailing Address - Fax:
Practice Address - Street 1:389 CAMINO SOBRANTE
Practice Address - Street 2:
Practice Address - City:ORINDA
Practice Address - State:CA
Practice Address - Zip Code:94563-1847
Practice Address - Country:US
Practice Address - Phone:925-330-3279
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-10-04
Last Update Date:2012-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFC52214106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist