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NPI Code Detail

MEDICARE: DR. FREDERICA CRAFTS DTCM, DIPL.OM, L.AC

MEDICARE:  DR. FREDERICA  CRAFTS  DTCM, DIPL.OM, L.AC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1171100000XAcupuncturist19524CA

General Provider Information

NPI Number : 1588350961
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. FREDERICA CRAFTS DTCM, DIPL.OM, L.AC
Provider Business Mailing Address
First Line : 2205 LAGOON CT
Second Line :
City : SANTA CRUZ
State : CA
Zip : 95062-4269
Country : US
Telephone Number : 617-515-1918
Fax Number :
Provider Business Practice Location Address
First Line : 6231 HIGHWAY 9 STE A
Second Line :
City : FELTON
State : CA
Zip : 95018-9710
Country : US
Telephone Number : 669-245-5130
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/18/2023
Last Update Date : 04/18/2023

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Directions to “ DR. FREDERICA CRAFTS DTCM, DIPL.OM, L.AC” Practice Location

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