Individual provider Active NPI

Isaac Joseph Frederick

  • Day Training/Habilitation Specialist
  • Belmont, CA
National Provider Identifier
1417225244
Registry record updated Jul 27, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Day Training/Habilitation SpecialistTaxonomy code 373H00000X
License
OH35778 Issued in CA
Practice address
310 Harbor Blvd BLDG E
Belmont, CA 94002-4018
Phone
(650) 802-3351
Fax
(650) 591-3043
NPI assigned
Dec 7, 2011
Last updated
Jul 27, 2026By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 27, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Day Training/Habilitation Specialist 373H00000X OH35778 CA Primary
Rehabilitation Practitioner 225400000X CA

Addresses

Primary practice location

310 Harbor Blvd BLDG E
Belmont, CA 94002-4018

Mailing address

310 Harbor Blvd BLDG E
Belmont, CA 94002-4018
Phone (650) 802-3351

Other practice location 1

2050 Fairmont Dr
San Leandro, CA 94578
Phone (510) 483-3030

Other identifiers 1

IdentifierTypeStateIssuer
1411033663OtherCAEMPLOYER ID NUMBER

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
OH35778CAMDMental Health Counselor

NPI Registry JSON

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

{
    "created_epoch": "1323216000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1785110400000",
    "number": "1417225244",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "310 HARBOR BLVD BLDG E",
            "city": "BELMONT",
            "state": "CA",
            "postal_code": "940024018",
            "telephone_number": "650-802-3351",
            "fax_number": "650-591-3043"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "310 HARBOR BLVD BLDG E",
            "city": "BELMONT",
            "state": "CA",
            "postal_code": "940024018",
            "telephone_number": "650-802-3351",
            "fax_number": "650-591-3043"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2050 Fairmont Dr",
            "address_purpose": "LOCATION",
            "city": "San Leandro",
            "state": "CA",
            "postal_code": "94578",
            "country_code": "US",
            "telephone_number": "510-483-3030",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FREDERICK",
        "first_name": "ISAAC",
        "middle_name": "JOSEPH",
        "name_prefix": "Mr.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-12-07",
        "last_updated": "2026-07-27",
        "certification_date": "2026-07-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "373H00000X",
            "taxonomy_group": "",
            "desc": "Day Training/Habilitation Specialist",
            "state": "CA",
            "license": "OH35778",
            "primary": true
        },
        {
            "code": "225400000X",
            "taxonomy_group": "",
            "desc": "Rehabilitation Practitioner",
            "state": "CA",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "EMPLOYER ID NUMBER",
            "identifier": "1411033663",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Belmont, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 27, 2026; 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.