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General NPI Number Information
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NPI Number | 1346103322
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Entity Type | Individual
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Provider Name | BIANCA C FREDERICK RN, PHN
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Gender | Female
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Dates
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Enumeration Date | 12/05/2025
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Last Update Date | 12/05/2025
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Provider Practice Location Address
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Address Line | 1840 BENTON ST
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City | SANTA CLARA
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State | CA
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Zip | 95050-5215
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Country | US
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Telephone | 408-210-3898
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Fax | 408-423-3620
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Provider Business Mailing Address
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Address Line | 2428 MORAINE DR
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City | SANTA CLARA
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State | CA
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Zip | 95051-1116
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Country | US
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Telephone | 408-219-5107
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Fax | 408-423-3620
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 163WS0200X
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Taxonomy Name | School Registered Nurse
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License Number | 487866
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License Number State | CA
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