Provider Demographics
NPI:1386143956
Name:FREITAS, LAURENCE JOSEPH (ND LAC MPH MPP)
Entity type:Individual
Prefix:DR
First Name:LAURENCE
Middle Name:JOSEPH
Last Name:FREITAS
Suffix:
Gender:M
Credentials:ND LAC MPH MPP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1608 MARIA AVE
Mailing Address - Street 2:
Mailing Address - City:SPRING VALLEY
Mailing Address - State:CA
Mailing Address - Zip Code:91977-4431
Mailing Address - Country:US
Mailing Address - Phone:619-272-2518
Mailing Address - Fax:619-437-4909
Practice Address - Street 1:1105 8TH ST
Practice Address - Street 2:
Practice Address - City:CORONADO
Practice Address - State:CA
Practice Address - Zip Code:92118-2217
Practice Address - Country:US
Practice Address - Phone:619-272-2518
Practice Address - Fax:619-732-4748
Is Sole Proprietor?:Yes
Enumeration Date:2018-02-08
Last Update Date:2025-01-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA18208171100000X
CAND962175F00000X, 202D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes202D00000XAllopathic & Osteopathic PhysiciansIntegrative Medicine
No171100000XOther Service ProvidersAcupuncturistGroup - Multi-Specialty
No175F00000XOther Service ProvidersNaturopathGroup - Multi-Specialty