Fredericks, Nicole L

Fredericks, Nicole L is an individual health care provider with primary practice located at 3 Medical Plaza Dr #100, Roseville CA 95661-3087. She recently has only one registered license in Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Occupational Therapist, which is considered as her primary health care specialty. Fredericks, Nicole L can be contacted via phone (916) 781-1157.

Contact Information

Primary practice address
3 Medical Plaza Dr #100 Roseville CA 95661-3087
Phone: (916) 781-1157
Fax: (916) 781-1118
Website:
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Health care specialties

SpecialtyCodeLicense #State
Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Occupational Therapist 225X00000X OT5986 California

Profile Details

NPI number 1215034384
LBN Legal business name Fredericks, Nicole L
Credentials Occupational Therapist (OT)
Entity Individual
Sole proprietor 1 No
Enumeration date Sep 20th, 2006
Last updated Jul 24th, 2015 - about 10 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1215034384 NPPES
California MEDICAID CT0059860

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