DR. KIM S FREDERICKSON


Address: 400 Professional Center Drive, Suite 414 Novato Dermatology Associates, Novato, CA 94947
Phone: 4158920754

DR. KIM S FREDERICKSON (NPI# 1003995291) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1003995291
Entity Type Individual
Full Name DR. KIM S FREDERICKSON
Credential MD
Practice Address 400 Professional Center Drive
Suite 414 Novato Dermatology Associates
Novato
CA 94947
Mailing Address 400 Professional Center Drive
Suite 414
Novato
CA 94947
Practice Telephone 4158920754
Practice Fax Number 4158973204
Mailing Telephone 4158920754
Mailing Fax Number 4158973204
Enumeration Date 2006-11-06
Last Update Date 2008-10-10
Gender Code F
Is Sole Proprietor N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 207N00000X Dermatology G79619 CA Allopathic & Osteopathic Physicians

Office Location

Street Address 400 PROFESSIONAL CENTER DRIVE
SUITE 414 NOVATO DERMATOLOGY ASSOCIATES
City NOVATO
State CA
Zip Code 94947

Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1407135882 Rainey Sealey Temkin Psychologist 1682 Novato Blvd Ste 105, Novato, CA 94947 2011-08-16
1801192786 Barbara Jean Gosselin Marriage & Family Therapist 1748 Novato Blvd Suite 210, Novato, CA 94947 2011-02-10
1659681377 Karen Ann Murphy Occupational Therapist 27 Stasia Dr., Novato, CA 94947 2010-10-15
1154659415 Christopher Michael Hackett Chiropractor 1559 South Novato Blvd., Suite E, Novato, CA 94947 2009-11-25
1003068305 Suttinee Saguandeekul Pharmacist 910 Diablo Ave, Novato, CA 94947 2008-10-17
1891983581 Shital Gandhi Radiology 500 Redwood Blvd Ste 300, Novato, CA 94947 2007-10-09
1356544126 Victoria Elizabeth Herzog Marriage & Family Therapist 1682 Novato Blvd, Suite 250a, Novato, CA 94947 2007-06-07
1912047655 Michael Craig Corder Chiropractor 1553 S Novato Blvd, A2 Corder Chiropractic Office, Novato, CA 94947 2007-02-08
1427106905 Jacob Kyle Leone Naturopath 1748 Novato Blvd, Suite 100, Novato, CA 94947 2007-01-08
1881756401 Mental Health Management I, Inc. Psychiatric Residential Treatment Facility 655 Canyon Road, Novato, CA 94947 2006-12-14
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Taxonomy Information

Taxonomy Code 207N00000X
Grouping Allopathic & Osteopathic Physicians
Classification Dermatology

Taxonomy Definition

A dermatologist is trained to diagnose and treat pediatric and adult patients with benign and malignant disorders of the skin, mouth, external genitalia, hair and nails, as well as a number of sexually transmitted diseases. The dermatologist has had additional training and experience in the diagnosis and treatment of skin cancers, melanomas, moles and other tumors of the skin, the management of contact dermatitis and other allergic and nonallergic skin disorders, and in the recognition of the skin manifestations of systemic (including internal malignancy) and infectious diseases. Dermatologists have special training in dermatopathology and in the surgical techniques used in dermatology. They also have expertise in the management of cosmetic disorders of the skin such as hair loss and scars and the skin changes associated with aging.
Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source] Additional Resources: American Board of Dermatology, 2007. http://www.abderm.org/ Board certification is provided by the American Board of Dermatology.

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1003960063 Novato Dermatology Associates A Medical Corporation Dermatology 867 Diablo Ave, Novato, CA 94947-4007 2007-01-23
1851483705 Axel W Hoke Dermatology 400 Professional Center Dr, #414, Novato, CA 94947 2006-09-29
1053318824 Stephen Lewis Dalton Dermatology 400 Professional Center Dr, Suite 414, Novato, CA 94947-4367 2005-07-07

Providers in the same taxonomy and state

NPI Name Taxonomy Address Enumeration
1275144024 Lumins Aesthetic and Wellness, Inc Dermatology 20281 Sw Birch St, Suite 201, Newport Beach, CA 92660 2020-08-14
1669081204 Lucy Boyadzhian Dermatology 7472 Melrose Ave, Los Angeles, CA 90046-7524 2020-07-29
1033730981 Adrianna Janell Browne, Md, Inc. Dermatology 8 Camino Encinas Ste 115, Orinda, CA 94563-3350 2020-05-01
1215564877 Jasmine Khachatrian Dermatology 302 Sierra Woods Dr, Sierra Madre, CA 91024-1015 2020-03-24
1386277499 Jessica Hsu, M.d.,inc Dermatology 1506 Chapman Avenue, Address Line 2, Orange, CA 92866 2020-02-17
1245862101 Yuval Bibi, A Professional Corporation Dermatology 7266 Franklin Ave Apt 321, Los Angeles, CA 90046-8324 2020-02-09
1457982001 Modesty Joy Isaguirre Dermatology 140 S Grand Ave, Glendora, CA 91741-4259 2020-02-03
1790322063 Mfc Dermatology Dermatology 3655 Lomita Blvd Ste 221, Torrance, CA 90505-1918 2019-12-05
1336784206 Barbara Kinkle Pa Inc., A Physician Assistant Corporation Dermatology 24575 Hunt Ave, Corning, CA 96021-8607 2019-11-14
1497399141 Dermatology Specialists Inc Dermatology 4765 Carmel Mountain Rd Ste 201, San Diego, CA 92130-6657 2019-11-05
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Competitor

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City NOVATO
Zip Code 94947

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Dataset Information

Data Provider Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES)
Jurisdiction Medicare & Medicaid

This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.

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