Provider Demographics
NPI:1023025194
Name:STICH, FREDERICK ADAMS III (PHD)
Entity Type:Individual
Prefix:DR
First Name:FREDERICK
Middle Name:ADAMS
Last Name:STICH
Suffix:III
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:448 REDCLIFF DR STE 13
Mailing Address - Street 2:
Mailing Address - City:REDDING
Mailing Address - State:CA
Mailing Address - Zip Code:96002-0159
Mailing Address - Country:US
Mailing Address - Phone:530-222-8687
Mailing Address - Fax:530-222-1710
Practice Address - Street 1:448 REDCLIFF DR STE 13
Practice Address - Street 2:
Practice Address - City:REDDING
Practice Address - State:CA
Practice Address - Zip Code:96002-0159
Practice Address - Country:US
Practice Address - Phone:530-222-8687
Practice Address - Fax:530-222-1710
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA17937103TC1900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounseling