Lara Ellen King-Frederick, N.P.

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

10643 Issued in CA

Practice address

16061 Bear Valley Rd
Suite 7
Hesperia, CA 92345-1730

Phone

(760) 948-0980

Fax

(760) 948-3510

NPI assigned

Apr 20, 2010

Last updated

Apr 20, 2010By 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

Other names 1

• Lara Ellen Frederick Other name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Nurse Practitioner

State licenses

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

{
    "created_epoch": "1271721600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1271721600000",
    "number": "1548587272",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16061 BEAR VALLEY RD",
            "address_2": "SUITE 7",
            "city": "HESPERIA",
            "state": "CA",
            "postal_code": "923451730",
            "telephone_number": "760-948-0980",
            "fax_number": "760-948-3510"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16061 BEAR VALLEY RD",
            "address_2": "SUITE 7",
            "city": "HESPERIA",
            "state": "CA",
            "postal_code": "923451730",
            "telephone_number": "760-948-0980",
            "fax_number": "760-948-3510"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KING-FREDERICK",
        "first_name": "LARA",
        "middle_name": "ELLEN",
        "credential": "N.P.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-04-20",
        "last_updated": "2010-04-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "10643",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "LARA",
            "last_name": "FREDERICK",
            "middle_name": "ELLEN",
            "credential": "RNC, MS, FNP, ET",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Chang PA Kim
• Diana Mi Kim, LIC. AC.
• Eugenie Heo Kim, DDS
• Sally Minji Kim
• Sara Kim
• Melissa Emely Kinsey
• Gamze Kircalioglu, FNP
• Alice Joy Kirk, LCSW
• Rosa Maria Kirk, CPT-1
• Brenda Louise Kueckels, D.D.S.

• Family Nurse Practitioner in Hesperia, CA
• Providers in Hesperia, CA by specialty
• Family Nurse Practitioner in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 20, 2010; 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.