Individual provider · Type 1 NPI

Michael Robert Frederiksen, 101YA0400X

Addiction (Substance Use Disorder) Counselor · French Camp, CA

NPI number 1609419951 Active

Practice location

500 W Hospital Rd
French Camp, CA 95231-9693

Call (209) 468-6857 Map

Mailing address

1212 N California St
Stockton, CA 95202-1552

Specialties and licenses

TaxonomyCodeLicense
Addiction (Substance Use Disorder) Counselor Primary 101YA0400XNone listed
Community Health Worker 172V00000X10139 (CA)

Addiction (Substance Use Disorder) Counselor: Definition to come...

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About NPI 1609419951

Michael Robert Frederiksen, 101YA0400X's National Provider Identifier is 1609419951, issued on Oct 18, 2019. The primary taxonomy on file is Addiction (Substance Use Disorder) Counselor (101YA0400X), and the practice location is in French Camp, CA. The record was last updated on May 20, 2024.