FREDRICK HOLMBERG (NPI# 1427618768) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1427618768 |
| Entity Type | Individual |
| Full Name | FREDRICK HOLMBERG |
| Practice Address |
1729 University Ave S Apt E40 Fairbanks AK 99709-4976 |
| Practice Telephone | 9078882970 |
| Mailing Telephone | 9078882970 |
| Enumeration Date | 2019-06-18 |
| Last Update Date | 2019-06-18 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 101YA0400X |
Counselor Specialization: Addiction (Substance Use Disorder) |
4485 | AK | Behavioral Health & Social Service Providers |
| Street Address |
1729 UNIVERSITY AVE S APT E40 |
| City | FAIRBANKS |
| State | AK |
| Zip Code | 99709-4976 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1255946810 | Beacon Monitoring Professional Services | Technician, Other | 745 Staffordshire Rd, Fairbanks, AK 99709 | 2020-09-10 |
| 1235629544 | Fairbanks Healing Space | Health Educator | 3875 Geist Road, Suite E #136, Fairbanks, AK 99709 | 2018-05-11 |
| 1609395409 | Shawn K Goggins | Counselor | 1423 Peger Road, Fairbanks, AK 99709 | 2017-09-12 |
| 1710433347 | Jay Titus | Technician/Technologist | 2884 Marina Drive, Fairbanks, AK 99709 | 2016-09-01 |
| 1710391610 | Hannah Summerfelt | Dentist | 3539 Thomas St, Fairbanks, AK 99709 | 2014-06-18 |
| 1629407325 | Diane Louise Mitchell | Nurse Practitioner | 4650 Harvard Cir, Fairbanks, AK 99709 | 2013-11-04 |
| 1407147929 | Christina Martz | Counselor | 1270 Summet Drive, Fairbanks, AK 99709 | 2011-05-02 |
| 1255652285 | Surgery Center of Fairbanks LLC | Clinic/Center | 2310 Peger Road, Fairbanks, AK 99709 | 2010-06-14 |
| 1962661835 | John Leo Hughes Jr Jr. | Dentist | 3437 Airport Way, Suite 205, Fairbanks, AL 99709 | 2008-06-05 |
| 1508042417 | Katherine E Johnson, Md PC | Ophthalmology | 2485 Chief William Drive, Suite 100, Fairbanks, AK 99709 | 2008-01-10 |
| Find all providers in zip 99709 | ||||
| Taxonomy Code | 101YA0400X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| Specialization | Addiction (Substance Use Disorder) |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1104438365 | Jalon Alexander Mccullough | Counselor | 542 4th Ave Ste B-101, Fairbanks, AK 99701-4707 | 2020-08-19 |
| 1881210474 | Restore Incorported | Counselor | 1095 Tena Ave, Fairbanks, AK 99701-1422 | 2020-06-19 |
| 1669094553 | Capricia Rochelle Cunningham | Counselor | 998 Blair Rd Apt A, Fairbanks, AK 99701-3214 | 2020-05-13 |
| 1972122158 | Jessica Robertson | Counselor | 1211 Cushman St, Fairbanks, AK 99701-4680 | 2020-04-08 |
| 1306483755 | Interior Aids Association | Counselor | 710 3rd Avenue, Fairbanks, AK 99701-4455 | 2019-12-04 |
| 1578119681 | Katelyn Finister | Counselor | 542 4th Ave # B101, Fairbanks, AK 99701-4707 | 2019-08-14 |
| 1063064103 | Christine Lynne Johnson | Counselor | 424 Ketchikan Ave, Fairbanks, AK 99701-3737 | 2019-07-09 |
| 1740849819 | Alyssa Marie Agnes | Counselor | 1521 S Cushman St, Fairbanks, AK 99701-6203 | 2019-06-11 |
| 1700441599 | Heather M Cripe | Counselor | 1089 Tazlina Ct, Fairbanks, AK 99701-1421 | 2019-05-07 |
| 1689239469 | Caleb Luna Thomas | Counselor | 542 4th Ave Ste B, Fairbanks, AK 99701-4707 | 2019-05-07 |
| Find all providers in FAIRBANKS | ||||
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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.