Provider Demographics
NPI:1275139925
Name:FREUNDLICH, MEGAN HARRIS (RD)
Entity Type:Individual
Prefix:MRS
First Name:MEGAN
Middle Name:HARRIS
Last Name:FREUNDLICH
Suffix:
Gender:F
Credentials:RD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15215 NATIONAL AVE STE 101
Mailing Address - Street 2:
Mailing Address - City:LOS GATOS
Mailing Address - State:CA
Mailing Address - Zip Code:95032-2425
Mailing Address - Country:US
Mailing Address - Phone:408-384-8143
Mailing Address - Fax:408-369-2273
Practice Address - Street 1:3232 DOVE ST
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92103-5548
Practice Address - Country:US
Practice Address - Phone:408-384-8143
Practice Address - Fax:408-369-2273
Is Sole Proprietor?:No
Enumeration Date:2020-12-08
Last Update Date:2020-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
86015702133N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133N00000XDietary & Nutritional Service ProvidersNutritionist