Active NPI
Brett Fredericks, O.D.
- Optometrist
- Salinas, CA
National Provider Identifier
1750408571
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- License
- 12576T
- Practice address
- 950 Circle Dr
Salinas, CA 93905-2150 - Phone
- (831) 757-1264
- Fax
- (831) 757-4812
- NPI assigned
- Mar 25, 2007
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist | 152W00000X | 12576T | CA | Primary |
Addresses
Primary practice location
950 Circle Dr
Salinas, CA 93905-2150
Mailing address
322 30TH Ave
Santa Cruz, CA 95062-5443
Phone (831) 566-0875
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
| License | State | Type | Specialty |
|---|---|---|---|
| 12576T | CA | MD | Optometrist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1174780800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1325030400000",
"number": "1750408571",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "322 30TH AVE",
"city": "SANTA CRUZ",
"state": "CA",
"postal_code": "950625443",
"telephone_number": "831-566-0875",
"fax_number": "831-462-5937"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "950 CIRCLE DR",
"city": "SALINAS",
"state": "CA",
"postal_code": "939052150",
"telephone_number": "831-757-1264",
"fax_number": "831-757-4812"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FREDERICKS",
"first_name": "BRETT",
"credential": "O.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-03-25",
"last_updated": "2011-12-28",
"status": "A"
},
"taxonomies": [
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "CA",
"license": "12576T",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Salinas, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 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.