| Doctor Name: | MRS. KRISTINA ALYCIA FREEBORN |
| NPI Number: | 1871915462 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | MA. CCC-SLP |
| License Number: | 19013 |
| Business Practice Address: | 6076 Bristol Pkwy Ste 105 Culver City, CA - 902306600 |
| Business Phone Number: | 6619791333 |
| Business Fax Number: | 6613870597 |
| Mailing Address: | 1570 E 17th St, SANTA ANA |
| State: | CA |
| Postal Code: | 927058502 |
| Phone Number: | 6619791333 |
| Fax Number: | 6613870597 |
| NPI Enumeration Date: | 01/15/2014 |
| NPI Last Update Date: | 01/15/2014 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 235Z00000X |
| License Number: | 19013 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | CA |
| Taxonomy Type: | Speech, Language and Hearing Service Providers |
| Taxonomy Classification: | Speech-Language Pathologist |
| Taxonomy Specialization: | |
| Taxonomy Definition: | A speech pathologist is a person qualified by a master |