Danielle Austin Fredricks

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

005194 Issued in CA

Practice address

13223 Black Mountain Rd # 1508
San Diego, CA 92129-2698

Phone

(858) 753-5082

NPI assigned

Aug 26, 2019

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

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.

• Radiant Speech Therapy, Inc.

  • Speech-Language Pathologist
  • San Diego, CA
  • NPI 1275010548
  NPD

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

{
    "created_epoch": "1566777600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1749254400000",
    "number": "1912554833",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6654 PEREGRINE PL",
            "city": "CARLSBAD",
            "state": "CA",
            "postal_code": "920114090",
            "telephone_number": "760-533-9009"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13223 BLACK MOUNTAIN RD # 1508",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921292698",
            "telephone_number": "858-753-5082"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FREDRICKS",
        "first_name": "DANIELLE",
        "middle_name": "AUSTIN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-08-26",
        "last_updated": "2025-06-07",
        "certification_date": "2025-06-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "CA",
            "license": "005194",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Justin Fredericks, DO
• Nicole Fredericks
• Melissa Frederickson, MS, CCC/SLP
• Ryan Anthony Frederiksen, MD
• Fredric a. Seldin, PH.D., PC
• Natalie Jean Fredricks, MA, AMFT
• Daniel Aaron Fredrickson, DMD
• Jenne Fredrickson
• Sarah Charlene Fredrickson
• Free Flow Health Acupuncture

• Speech-Language Pathologist in San Diego, CA
• Providers in San Diego, CA by specialty
• Speech-Language Pathologist in California

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