Individual provider Active NPI

Jo Ann Elizabeth Friedrich, PHYSICIAN ASSISTANT

  • Medical Physician Assistant
  • Gold River, CA
National Provider Identifier
1689717480
Registry record updated Nov 28, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
PA10275 Issued in CA
Practice address
12155 Tributary Point Drive
#158
Gold River, CA 95670
Phone
(209) 815-1928
NPI assigned
Feb 14, 2007
Last updated
Nov 28, 2011By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 28, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X PA10275 CA Primary

Addresses

Primary practice location

12155 Tributary Point Drive
#158
Gold River, CA 95670

Mailing address

12155 Tributary Point Drive
#158
Gold River, CA 95670
Phone (209) 815-1928

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
Credentials
Physician Assistant

NPI Registry JSON

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

{
    "created_epoch": "1171411200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1322438400000",
    "number": "1689717480",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12155 TRIBUTARY POINT DRIVE",
            "address_2": "#158",
            "city": "GOLD RIVER",
            "state": "CA",
            "postal_code": "95670",
            "telephone_number": "209-815-1928"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12155 TRIBUTARY POINT DRIVE",
            "address_2": "#158",
            "city": "GOLD RIVER",
            "state": "CA",
            "postal_code": "95670",
            "telephone_number": "209-815-1928"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FRIEDRICH",
        "first_name": "JO ANN",
        "middle_name": "ELIZABETH",
        "credential": "PHYSICIAN ASSISTANT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-02-14",
        "last_updated": "2011-11-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "CA",
            "license": "PA10275",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Gold River, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 28, 2011; 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.