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NPI Code Detail

MEDICARE: LAURA M FREDERICK LMFT

MEDICARE:   LAURA M FREDERICK  LMFT
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
1106H00000XMarriage & Family Therapist90467CA

General Provider Information

NPI Number : 1114164662
Entity Type Code : Individual
Provider Name (Legal Business Name) : LAURA M FREDERICK LMFT
Provider Business Mailing Address
First Line : PO BOX 1372
Second Line :
City : ROCKLIN
State : CA
Zip : 95677-7372
Country : US
Telephone Number : 916-757-7514
Fax Number :
Provider Business Practice Location Address
First Line : 401 VERNON ST STE B
Second Line :
City : ROSEVILLE
State : CA
Zip : 95678-2600
Country : US
Telephone Number : 916-757-7514
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/20/2009
Last Update Date : 11/24/2025

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Directions to “ LAURA M FREDERICK LMFT” Practice Location

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