Healthcare Provider Details

I. General information

NPI: 1033255948
Provider Name (Legal Business Name): JILL FRIZZELL LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/29/2007
Last Update Date: 07/01/2026
Certification Date: 07/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

437A HUDSON ST
HEALDSBURG CA
95448-4461
US

IV. Provider business mailing address

PO BOX 81
HEALDSBURG CA
95448-0081
US

V. Phone/Fax

Practice location:
  • Phone: 707-362-1709
  • Fax:
Mailing address:
  • Phone: 707-362-1709
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number24698
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: