Provider Demographics
NPI:1265029466
Name:FREUND, SERAPHINA DOLORES (DC)
Entity Type:Individual
Prefix:
First Name:SERAPHINA
Middle Name:DOLORES
Last Name:FREUND
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:641 E BLITHEDALE AVE
Mailing Address - Street 2:STE A
Mailing Address - City:MILL VALLEY
Mailing Address - State:CA
Mailing Address - Zip Code:94941-1477
Mailing Address - Country:US
Mailing Address - Phone:415-866-0003
Mailing Address - Fax:
Practice Address - Street 1:641 E BLITHEDALE AVE
Practice Address - Street 2:STE A
Practice Address - City:MILL VALLEY
Practice Address - State:CA
Practice Address - Zip Code:94941-1477
Practice Address - Country:US
Practice Address - Phone:415-866-0003
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-12-22
Last Update Date:2021-05-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC36006111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor