Provider Demographics
NPI:1235697558
Name:FREITAS, CHARLENE JOY (FNP)
Entity type:Individual
Prefix:
First Name:CHARLENE
Middle Name:JOY
Last Name:FREITAS
Suffix:
Gender:
Credentials:FNP
Other - Prefix:
Other - First Name:CHARLENE
Other - Middle Name:J
Other - Last Name:LUMANLAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:28300 HUNTWOOD AVE
Mailing Address - Street 2:
Mailing Address - City:HAYWARD
Mailing Address - State:CA
Mailing Address - Zip Code:94544-5425
Mailing Address - Country:US
Mailing Address - Phone:510-471-5880
Mailing Address - Fax:
Practice Address - Street 1:28300 HUNTWOOD AVE
Practice Address - Street 2:
Practice Address - City:HAYWARD
Practice Address - State:CA
Practice Address - Zip Code:94544-5425
Practice Address - Country:US
Practice Address - Phone:510-471-5880
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-03-05
Last Update Date:2025-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95010226363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily