Jennifer Louise Fredenburg, M.S., CCC-SLP

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

30530 Issued in CA

Practice address

645 Tamalpais Dr
Corte Madera, CA 94925-1613

Phone

(415) 924-2444

NPI assigned

Sep 21, 2020

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other names 1

• Ms. Jennifer Louise Hirst Former name

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Science

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1600646400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1600646400000",
    "number": "1093321366",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "645 TAMALPAIS DR",
            "city": "CORTE MADERA",
            "state": "CA",
            "postal_code": "949251613",
            "telephone_number": "415-924-2444"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "645 TAMALPAIS DR",
            "city": "CORTE MADERA",
            "state": "CA",
            "postal_code": "949251613",
            "telephone_number": "415-924-2444"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FREDENBURG",
        "first_name": "JENNIFER",
        "middle_name": "LOUISE",
        "name_prefix": "Ms.",
        "credential": "M.S., CCC-SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-09-21",
        "last_updated": "2020-09-21",
        "certification_date": "2020-09-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "CA",
            "license": "30530",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "jen@speechmarin.com",
            "affiliation": "N",
            "address_1": "645 Tamalpais Dr",
            "city": "Corte Madera",
            "state": "CA",
            "country_code": "US",
            "postal_code": "949251613",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "JENNIFER",
            "last_name": "HIRST",
            "middle_name": "LOUISE",
            "prefix": "MS.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Sarah Fowler
• Susan Terese Fox, DACM, L.AC.
• David Jay Frankel, PH.D.
• Jennifer Hadley Frankel, M.D.
• Fred J Cameron DDS Inc
• L. Bradley Freed, MFT
• Sharon R. Freeman, O.D.
• Page Freyermuth
• Max Benjamin Fried
• Tina Gabby, MD

• Speech-Language Pathologist in Corte Madera, CA
• Providers in Corte Madera, CA by specialty
• Speech-Language Pathologist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 21, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.