Provider Demographics
NPI:1912526054
Name:FREEMAN, MICHAI (MA)
Entity type:Individual
Prefix:MS
First Name:MICHAI
Middle Name:
Last Name:FREEMAN
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1801 UNIVERSITY AVE UNIT 207
Mailing Address - Street 2:
Mailing Address - City:BERKELEY
Mailing Address - State:CA
Mailing Address - Zip Code:94703-1594
Mailing Address - Country:US
Mailing Address - Phone:510-326-8718
Mailing Address - Fax:
Practice Address - Street 1:1801 UNIVERSITY AVE UNIT 207
Practice Address - Street 2:
Practice Address - City:BERKELEY
Practice Address - State:CA
Practice Address - Zip Code:94703-1594
Practice Address - Country:US
Practice Address - Phone:510-326-8718
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-04-09
Last Update Date:2020-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174H00000XOther Service ProvidersHealth EducatorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NONEOtherNONE