Provider Demographics
NPI:1164202370
Name:FREITAS FAMILY THERAPY INC
Entity Type:Organization
Organization Name:FREITAS FAMILY THERAPY INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:CASSIDY
Authorized Official - Middle Name:JUNE ESPANA
Authorized Official - Last Name:FREITAS
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:858-480-5314
Mailing Address - Street 1:4540 KEARNY VILLA RD STE 210
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92123-1586
Mailing Address - Country:US
Mailing Address - Phone:858-480-5314
Mailing Address - Fax:
Practice Address - Street 1:4540 KEARNY VILLA RD STE 210
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92123-1586
Practice Address - Country:US
Practice Address - Phone:858-480-5314
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-10-04
Last Update Date:2023-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Multi-Specialty
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Multi-Specialty
No103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Multi-Specialty
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty