Provider Demographics
NPI:1619449105
Name:SUZANNA FREERKSEN, MD, INC.
Entity Type:Organization
Organization Name:SUZANNA FREERKSEN, MD, INC.
Other - Org Name:RECLAIM JOY MEDICAL
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:SUZANNA
Authorized Official - Middle Name:
Authorized Official - Last Name:FREERKSEN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:669-242-5151
Mailing Address - Street 1:3141 STEVENS CREEK BLVD STE 40141
Mailing Address - Street 2:
Mailing Address - City:SAN JOSE
Mailing Address - State:CA
Mailing Address - Zip Code:95117-1141
Mailing Address - Country:US
Mailing Address - Phone:669-242-5151
Mailing Address - Fax:669-242-5152
Practice Address - Street 1:4633 OLD IRONSIDES DR STE 210
Practice Address - Street 2:
Practice Address - City:SANTA CLARA
Practice Address - State:CA
Practice Address - Zip Code:95054-1836
Practice Address - Country:US
Practice Address - Phone:669-242-5151
Practice Address - Fax:669-242-5152
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-12-20
Last Update Date:2022-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Single Specialty