Individual provider Active NPI

Fredrick Lee Polizo, DC

  • Chiropractor
  • Santa Barbara, CA
National Provider Identifier
1659855054
Registry record updated Sep 20, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
33783 Issued in CA
Practice address
18 W Micheltorena St Ste a
Santa Barbara, CA 93101-6528
Phone
(805) 637-0414
NPI assigned
Sep 20, 2018
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 20, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 33783 CA Primary

Addresses

Primary practice location

18 W Micheltorena St Ste a
Santa Barbara, CA 93101-6528

Mailing address

102 W Constance Ave Apt 6
Santa Barbara, CA 93105-3944
Phone (805) 637-0414

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
33783CAMDClinical Psychologist

NPI Registry JSON

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

{
    "created_epoch": "1537401600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1537401600000",
    "number": "1659855054",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "102 W CONSTANCE AVE APT 6",
            "city": "SANTA BARBARA",
            "state": "CA",
            "postal_code": "931053944",
            "telephone_number": "805-637-0414"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18 W MICHELTORENA ST STE A",
            "city": "SANTA BARBARA",
            "state": "CA",
            "postal_code": "931016528",
            "telephone_number": "805-637-0414"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "POLIZO",
        "first_name": "FREDRICK",
        "middle_name": "LEE",
        "name_prefix": "Dr.",
        "credential": "DC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2018-09-20",
        "last_updated": "2018-09-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "CA",
            "license": "33783",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Santa Barbara, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 20, 2018; 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.