Healthcare Provider Details

I. General information

NPI: 1629082706
Provider Name (Legal Business Name): BRENDA FRECHETTE PHD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/27/2006
Last Update Date: 11/11/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

292 ALAMO DR SUITE 3
VACAVILLE CA
95688-4243
US

IV. Provider business mailing address

292 ALAMO DR SUITE 3
VACAVILLE CA
95688-4243
US

V. Phone/Fax

Practice location:
  • Phone: 707-438-5808
  • Fax:
Mailing address:
  • Phone: 707-438-5808
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103T00000X
TaxonomyPsychologist
License NumberPSY 21930
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: