Gail June Fredericks, MD

Primary specialty

General Practice PhysicianTaxonomy code 208D00000X

License

A61646 Issued in CA

Practice address

121 Diana St
Placerville, CA 95667-3313

Phone

(530) 559-2880

Fax

(530) 622-2979

NPI assigned

Oct 6, 2006

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 identifiers 2

Other names 1

• Gail June Russell Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

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

• Cogent Healthcare of California, PC

  • Internal Medicine Physician
  • San Bernardino, CA
  • NPI 1366681074
  NPD (past)

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

{
    "created_epoch": "1160092800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678147200000",
    "number": "1659468999",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "121 DIANA ST",
            "city": "PLACERVILLE",
            "state": "CA",
            "postal_code": "956673313",
            "telephone_number": "530-559-2880",
            "fax_number": "530-622-2979"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "121 DIANA ST",
            "city": "PLACERVILLE",
            "state": "CA",
            "postal_code": "956673313",
            "telephone_number": "530-559-2880",
            "fax_number": "530-622-2979"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FREDERICKS",
        "first_name": "GAIL",
        "middle_name": "JUNE",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-06",
        "last_updated": "2023-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "CA",
            "license": "A61646",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00A616460",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CLIA ID NO",
            "identifier": "05D0932276",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "GAIL",
            "last_name": "RUSSELL",
            "middle_name": "JUNE",
            "credential": "MD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Fosteringconnections L.L.C
• Loretta Ann Frank
• Nicole Yvonne Franklin, M.D.
• Heather Ann Frazee
• Mark Frazier, RADTI
• Chelsea Fredlund, LM, CPM
• Judith Ann French, MFC
• Andrea Marie Fritschle, M.D.
• Bonnie Ballou Fuchs
• Jonathan Brett Fugitt, M.D.

• General Practice Physician in Placerville, CA
• Providers in Placerville, CA by specialty
• General Practice Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2023; 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.