Provider Demographics
NPI:1396594347
Name:FREEMAN-ROSS, JAMIE
Entity type:Individual
Prefix:MRS
First Name:JAMIE
Middle Name:
Last Name:FREEMAN-ROSS
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 1:5445 THILLE ST
Mailing Address - Street 2:
Mailing Address - City:VENTURA
Mailing Address - State:CA
Mailing Address - Zip Code:93003-0409
Mailing Address - Country:US
Mailing Address - Phone:909-994-0465
Mailing Address - Fax:
Practice Address - Street 1:5445 THILLE ST
Practice Address - Street 2:
Practice Address - City:VENTURA
Practice Address - State:CA
Practice Address - Zip Code:93003-0409
Practice Address - Country:US
Practice Address - Phone:909-994-0465
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-05-14
Last Update Date:2024-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA130022719374J00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374J00000XNursing Service Related ProvidersDoula