Healthcare Provider Details

I. General information

NPI: 1154589273
Provider Name (Legal Business Name): DR. ERIC FRENETTE
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/27/2008
Last Update Date: 05/27/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

401 QUARRY ROAD SUITE 3301
STANFORD CA
94305
US

IV. Provider business mailing address

401 QUARRY ROAD SUITE 3301
STANFORD CA
94305
US

V. Phone/Fax

Practice location:
  • Phone: 650-723-6601
  • Fax: 650-725-8910
Mailing address:
  • Phone: 650-723-6601
  • Fax: 650-725-8910

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084S0012X
TaxonomySleep Medicine (Psychiatry & Neurology) Physician
License NumberA101440
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: