Provider Demographics
NPI:1619031564
Name:FREE, OCEANA (MFT)
Entity type:Individual
Prefix:MS
First Name:OCEANA
Middle Name:
Last Name:FREE
Suffix:
Gender:F
Credentials:MFT
Other - Prefix:MS
Other - First Name:OCEANA
Other - Middle Name:
Other - Last Name:FREE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MFT
Mailing Address - Street 1:1220 ROSECRANS ST
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92106-2674
Mailing Address - Country:US
Mailing Address - Phone:619-908-2363
Mailing Address - Fax:
Practice Address - Street 1:1220 ROSECRANS ST
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92106-2674
Practice Address - Country:US
Practice Address - Phone:619-908-2363
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-21
Last Update Date:2024-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA49053106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist