Individual provider Active NPI

Julia A Friesen, NP

  • Pediatric Nurse Practitioner
  • Woodland, CA
National Provider Identifier
1225057847
Registry record updated Mar 30, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Nurse PractitionerTaxonomy code 363LP0200X
License
NP10166 Issued in CA
Practice address
632 W Gibson Rd
Woodland, CA 95695
Phone
(530) 666-1631
Fax
(530) 668-4839
NPI assigned
Jul 18, 2006
Last updated
Mar 30, 2010By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 30, 2010

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Nurse Practitioner 363LP0200X NP10166 CA Primary
Registered Nurse 163W00000X 377494 CA

Addresses

Primary practice location

632 W Gibson Rd
Woodland, CA 95695

Mailing address

632 W Gibson Rd
Woodland, CA 95695
Phone (530) 666-1631

Other identifiers 1

IdentifierTypeStateIssuer
RN377494OtherCAMEDI-CAL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050111000787 CA Practitioner - Nurse Practitioner 0547218018 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
377494CAMDRegistered Nurse
NP10166CAMDPediatric Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Dignity Health Medical Foundation Current Accepting new patients
Dignity Community Care Past Accepting new patients

Locations

3400 Data Dr
Rncho Cordova, CA 95670
Phone (916) 379-2726

2081 Bronze Star Dr
Woodland, CA 95776
Phone (530) 668-2600

632 W Gibson Rd
Woodland, CA 95695
Phone (530) 666-1631

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1153180800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1269907200000",
    "number": "1225057847",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "632 W GIBSON RD",
            "city": "WOODLAND",
            "state": "CA",
            "postal_code": "95695",
            "telephone_number": "530-666-1631"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "632 W GIBSON RD",
            "city": "WOODLAND",
            "state": "CA",
            "postal_code": "95695",
            "telephone_number": "530-666-1631",
            "fax_number": "530-668-4839"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FRIESEN",
        "first_name": "JULIA",
        "middle_name": "A",
        "name_prefix": "Ms.",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-18",
        "last_updated": "2010-03-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "CA",
            "license": "NP10166",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "CA",
            "license": "377494",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDI-CAL",
            "identifier": "RN377494",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Woodland, CA

Sources for this page

Verify at the official NPI Registry.