Provider Demographics
NPI:1265741888
Name:FREEMAN, ANDREA MISCAL (DPT)
Entity type:Individual
Prefix:DR
First Name:ANDREA
Middle Name:MISCAL
Last Name:FREEMAN
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:DR
Other - First Name:ANDREA
Other - Middle Name:MISCAL
Other - Last Name:HARNDEN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DPT
Mailing Address - Street 1:2941 FELSTET LN
Mailing Address - Street 2:
Mailing Address - City:REDDING
Mailing Address - State:CA
Mailing Address - Zip Code:96001-4220
Mailing Address - Country:US
Mailing Address - Phone:530-917-5085
Mailing Address - Fax:
Practice Address - Street 1:6401 CADILLAC AVE
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90034
Practice Address - Country:US
Practice Address - Phone:818-323-2000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-09-30
Last Update Date:2010-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA35326225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist