Dr. Kim S Frederickson
Dermatologist
400 Professional Center Drive Suite 414 Novato Dermatology Associates
Novato
, California 94947
Dr. Kim S Frederickson
Dermatologist
400 Professional Center Drive Suite 414 Novato Dermatology Associates
Novato
, California 94947
(415) 897-3204
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About
Features
Specialties
- Dermatologist
Languages spoken
- English
Location
First Address
- Dr. Kim S Frederickson
- 400 Professional Center Drive Suite 414
- Novato, CA
- Zip : 94947
- Fax : (415) 897-3204
- Phone : (415) 892-0754
Second Address
- Dr. Kim S Frederickson
- 400 Professional Center Drive Suite 414 Novato Dermatology Associates
- Novato, CA
- Zip : 94947
- Fax : (415) 897-3204
- Phone : (415) 892-0754
Reviews
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| Y | 207N00000X | Dermatologist | G79619 | CA |
National Provider Identifier
| NPI | 1003995291 |
|---|---|
| Provider Name | Dr. Kim S Frederickson |
| First Address | Novato, CA 94947 |
| Second Address | Novato, CA 94947 |
| Gender | F |
| NPI Entity type | Individual |
| Is Sole Proprietor | No |
| Is Organization Subpart | N/A |
| Enumeration Date | 06/11/2006 |
| Last Update Date | 10/10/2008 |
Additional Identifiers
| IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
|---|---|---|
| G69391 | (02) |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.