MRS. KATIE LEE FREDERICKSON (NPI# 1104237544) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1104237544 |
| Entity Type | Individual |
| Full Name | MRS. KATIE LEE FREDERICKSON |
| Credential | FNP-BC |
| Practice Address |
2438 N Ponderosa Dr C-105 Camarillo CA 93010-2369 |
| Practice Telephone | 8053882068 |
| Practice Fax Number | 8054847700 |
| Mailing Telephone | 8053882068 |
| Mailing Fax Number | 8054847700 |
| Enumeration Date | 2014-05-19 |
| Last Update Date | 2014-05-19 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LF0000X |
Nurse Practitioner Specialization: Family |
NP95000513 | CA | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
2438 N PONDEROSA DR C-105 |
| City | CAMARILLO |
| State | CA |
| Zip Code | 93010-2369 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1902805294 | Calbert A Wong | Internal Medicine | 2438 N Ponderosa Dr, # C-101, Camarillo, CA 93010-2369 | 2005-07-19 |
| 1164819769 | Christopher W. Loh Md Apc | Internal Medicine | 2438 N Ponderosa Dr, Suite C201, Camarillo, CA 93010-2369 | 2015-04-21 |
| 1932534021 | Renal Consultants of Ventura County, Inc | Internal Medicine | 2438 N Ponderosa Dr, Suite # C-101, Camarillo, CA 93010-2369 | 2013-09-06 |
| 1104178193 | Lisa Elaine Brand | Surgery | 2438 N Ponderosa Dr, Ste C207, Camarillo, CA 93010-2374 | 2012-10-15 |
| 1952611394 | Nuclear Medicine Associates, Inc. | Nuclear Medicine | 2438 N Ponderosa Dr, Building C, Suite #201, Camarillo, CA 93010-2369 | 2010-10-19 |
| 1013246719 | Total Renal Care Inc | Clinic/Center | 2438 N Ponderosa Dr, Ste C101, Camarillo, CA 93010-2465 | 2009-12-09 |
| 1982849436 | Erin Nicole Ghaffari | Dietitian, Registered | 2438 N Ponderosa Dr, Unit C-101, Camarillo, CA 93010-2369 | 2008-12-12 |
| 1992988521 | Neal P. Dixon, M.d., A General Surgical Medical Corporation | Surgery | 2438 N Ponderosa Dr, C-207, Camarillo, CA 93010-2369 | 2007-12-05 |
| 1033328547 | Leopold Weinstein | Dentist | 2438 N Ponderosa Dr, Suite C217, Camarillo, CA 93010 | 2007-05-21 |
| 1073673273 | Susan S. Chang | Internal Medicine | 2438 N Ponderosa Dr, Suite # C-101, Camarillo, CA 93010-2369 | 2006-12-11 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1588261366 | Edith Gallardo | Behavior Technician | 400 Mobile Avenue Suite A-3, Camarillo, CA 93010 | 2020-10-05 |
| 1568094761 | Amanda Montoya | Physical Therapist | 58 Calle Escalon, Camarillo, CA 93010 | 2020-02-06 |
| 1518509678 | Esther Marie Brown Gonzalez | Technician | 2826 Munson St, Camarilla, CA 93010 | 2019-10-10 |
| 1023666385 | Nancy Monetta Wigert | Speech-Language Pathologist | 155 Granada Street #a, Camarillo, CA 93010 | 2019-08-29 |
| 1174098651 | Tatianna Kraft | Counselor | 4243 Vincente Ave, Camarillo, CA 93010 | 2018-10-10 |
| 1861977662 | Marina Wischnack | Psychologist | 1200 Paseo Camarillo, Suite 245, Camarillo, CA 93010 | 2018-09-27 |
| 1417430620 | Peter Lawrence Mcdermott | Anesthesiology | 141 Lapatera Drive, Camarillo, CA 93010 | 2018-09-13 |
| 1689162521 | Mehgan Lynn Lambert | Specialist | 333 Skyway Drive, Camarillo, CA 93010 | 2018-04-26 |
| 1134643208 | Hailey Kay Kohler | Social Worker | 692 Spring Oak Road Unit 721, Camarillo, CA 93010 | 2017-08-01 |
| 1174052369 | Demi Shugrue | Counselor | 2021 Sperry Ave, Suite 37, Ventura, CA 93010 | 2017-06-09 |
| Find all providers in zip 93010 | ||||
| Taxonomy Code | 363LF0000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Family |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1881173250 | Megan Reider | Nurse Practitioner | 268 Village Commons Blvd Unit 19, Camarillo, CA 93012-6828 | 2018-08-07 |
| 1811480502 | Aaron Mehlman | Nurse Practitioner | 415 W Ventura Blvd Ste 200, Camarillo, CA 93010-9128 | 2018-06-07 |
| 1275991184 | Lauren Elizabeth Mcwhorter | Nurse Practitioner | 1040 Flynn Rd, Camarillo, CA 93012-5092 | 2016-02-05 |
| 1780084483 | Karen Vordale | Nurse Practitioner | 3901 East Las Posas Rd, Ste #204, Camarillo, CA 93010-1501 | 2014-08-29 |
| 1427460856 | Aristotle Ibarra Tuano | Nurse Practitioner | 3406 Rockhampton Dr, Camarillo, CA 93012-7735 | 2014-05-20 |
| 1023323334 | Brenda Kim Means | Nurse Practitioner | 3801 Las Posas Rd Ste 106, Camarillo, CA 93010-1425 | 2010-08-11 |
| 1699086769 | Terry L Schneider | Nurse Practitioner | 751 E Daily Dr, Suite 120, Camarillo, CA 93010-6076 | 2010-06-23 |
| 1558691667 | Laurel Jean Coppage | Nurse Practitioner | 1051 Centennial Ave, Camarillo, CA 93010-4715 | 2010-01-12 |
| 1427240738 | Leslie Ann Somma | Nurse Practitioner | 1901 North Solar Dr, Suite 115, Camarillo, CA 93036 | 2007-08-10 |
| 1154322311 | Rosalind S. Ng | Nurse Practitioner | 1 University Dr, Cal State University Channel Islands Student Health, Camarillo, CA 93012-8599 | 2005-08-09 |
| Find all providers in CAMARILLO | ||||
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| 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.