Provider Demographics
NPI:1841830759
Name:FREITAS, KEVIN LEONARD
Entity type:Individual
Prefix:MR
First Name:KEVIN
Middle Name:LEONARD
Last Name:FREITAS
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:176 E 2ND AVE
Mailing Address - Street 2:
Mailing Address - City:CHICO
Mailing Address - State:CA
Mailing Address - Zip Code:95926-3321
Mailing Address - Country:US
Mailing Address - Phone:415-513-2527
Mailing Address - Fax:
Practice Address - Street 1:560 COHASSET RD STE 185
Practice Address - Street 2:
Practice Address - City:CHICO
Practice Address - State:CA
Practice Address - Zip Code:95926-2460
Practice Address - Country:US
Practice Address - Phone:530-891-2810
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-01-08
Last Update Date:2020-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty