Provider Demographics
NPI:1093008153
Name:WONG, FREEDA (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:FREEDA
Middle Name:
Last Name:WONG
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1750 NORIEGA ST
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94122-4308
Mailing Address - Country:US
Mailing Address - Phone:415-664-5543
Mailing Address - Fax:415-664-6195
Practice Address - Street 1:1750 NORIEGA ST
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94122-4308
Practice Address - Country:US
Practice Address - Phone:415-664-5543
Practice Address - Fax:415-664-6195
Is Sole Proprietor?:Yes
Enumeration Date:2011-05-24
Last Update Date:2023-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA47267183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist