Provider Demographics
NPI:1750634812
Name:FREEMAN, FAITH (CPM LM)
Entity Type:Individual
Prefix:
First Name:FAITH
Middle Name:
Last Name:FREEMAN
Suffix:
Gender:F
Credentials:CPM LM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:610 S MAIN ST # 205
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90014-2009
Mailing Address - Country:US
Mailing Address - Phone:918-688-7919
Mailing Address - Fax:855-701-3163
Practice Address - Street 1:453 S SPRING ST STE 523
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90013-2077
Practice Address - Country:US
Practice Address - Phone:323-536-2998
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-10-25
Last Update Date:2021-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA549176B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes176B00000XOther Service ProvidersMidwife
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA549OtherCA STATE LICENSING BOARD