Provider Demographics
NPI:1811230865
Name:FREIRE, PRISCILLA CONSUELO
Entity Type:Individual
Prefix:
First Name:PRISCILLA
Middle Name:CONSUELO
Last Name:FREIRE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:555 FRANKLIN ST
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94102
Mailing Address - Country:US
Mailing Address - Phone:321-418-4822
Mailing Address - Fax:
Practice Address - Street 1:33841 ROBLES DR
Practice Address - Street 2:APT B
Practice Address - City:DANA POINT
Practice Address - State:CA
Practice Address - Zip Code:92629-5222
Practice Address - Country:US
Practice Address - Phone:321-418-4822
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-03-28
Last Update Date:2013-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2355S0801XSpeech, Language and Hearing Service ProvidersSpecialist/TechnologistSpeech-Language Assistant