Justin Fredericks

Primary specialty

Marriage & Family TherapistTaxonomy code 106H00000X

License

152945 Issued in CA

Practice address

9121 Folsom Blvd
Sacramento, CA 95826-2473

Phone

(916) 516-1865

NPI assigned

Jan 12, 2024

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

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.

• Akua Behavioral Health, Inc

  • Substance Abuse Rehabilitation Facility
  • Sacramento, CA
  • NPI 1013651173
  NPD
• Anchor Therapy Clinic

  • Community/Behavioral Health Agency
  • Sacramento, CA
  • NPI 1720557721
  NPD (past)

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

{
    "created_epoch": "1705017600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1741132800000",
    "number": "1851162408",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7609 MCTAVISH CIR",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958284337",
            "telephone_number": "707-564-8020"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9121 FOLSOM BLVD",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958262473",
            "telephone_number": "916-516-1865"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FREDERICKS",
        "first_name": "JUSTIN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-01-12",
        "last_updated": "2025-03-05",
        "certification_date": "2025-03-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "152945",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Fred Behavior Consulting LLC
• Fred R Samimi, MD, a Professional Corporation
• Milton C. Fredenburg, DPM
• Paige Herse Fredenburg
• Charles Fredericks, M.D.
• Cynthia Louise Frederickson, AUD
• Matthew Ryan Frederickson, MD
• Willard Lee Frederickson, M.D.
• Christine Fredrickson, BCBA
• Lauryn Fredrickson

• Marriage & Family Therapist in Sacramento, CA
• Providers in Sacramento, CA by specialty
• Marriage & Family Therapist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 5, 2025; 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.