Marti Harris Fredericks, LMFT

Primary specialty

Marriage & Family TherapistTaxonomy code 106H00000X

License

M13967 Issued in CA

Practice address

5361 N Pershing Ave Ste H
Stockton, CA 95207-5450

Phone

(209) 477-9177

Fax

(209) 477-4667

NPI assigned

Mar 7, 2008

Last updated

Mar 7, 2008By the provider in NPPES

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

Medicare fee-for-service enrollment

Enrolled in CA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Marriage and Family Therapist

Education

Other, 1974

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Sud Specialty Group - Ca

  dba Rula Health

  • Addiction Medicine (Psychiatry & Neurology) Physician
  • Santa Clara, CA
  • NPI 1972138238

  Marriage & Family Therapist

  Medicare reassignment NPD
• Human Services Project, Inc

  • Mental Illness Community Based Residential Treatment Facility
  • Stockton, CA
  • NPI 1366750226
  Authorized official Same address or phone
• Human Services Projects, Inc.

  dba Community Behavioral Intervention Services

  • Community/Behavioral Health Agency
  • Stockton, CA
  • NPI 1710168158
  Authorized official Same address or phone

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

{
    "created_epoch": "1204848000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1204848000000",
    "number": "1215107065",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5361 N PERSHING AVE STE H",
            "city": "STOCKTON",
            "state": "CA",
            "postal_code": "952075450",
            "telephone_number": "209-477-9177",
            "fax_number": "209-477-4667"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5361 N PERSHING AVE STE H",
            "city": "STOCKTON",
            "state": "CA",
            "postal_code": "952075450",
            "telephone_number": "209-477-9177",
            "fax_number": "209-477-4667"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FREDERICKS",
        "first_name": "MARTI",
        "middle_name": "HARRIS",
        "name_prefix": "Mrs.",
        "credential": "LMFT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-03-07",
        "last_updated": "2008-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "M13967",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• John Frassetto, PT
• Roza Renee Fray, FNP
• Ashlee Frazier
• Marcella Frazier
• Tonya Yvette Frazier
• Margaret P Frederickson, RPH
• Kristina Renee Fredrick-Pond
• Breeana Lee Fredricksen, C-SLPA
• Taylor Allysa Fredricksen
• Ashley Freeman

• Marriage & Family Therapist in Stockton, CA
• Providers in Stockton, CA by specialty
• Marriage & Family Therapist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.