Provider Demographics
NPI:1689894842
Name:FREDRICKSON, HILLARY JOSEPH (ND)
Entity Type:Individual
Prefix:DR
First Name:HILLARY
Middle Name:JOSEPH
Last Name:FREDRICKSON
Suffix:
Gender:F
Credentials:ND
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 2041
Mailing Address - Street 2:
Mailing Address - City:SAN ANSELMO
Mailing Address - State:CA
Mailing Address - Zip Code:94979-2041
Mailing Address - Country:US
Mailing Address - Phone:415-497-0148
Mailing Address - Fax:415-787-7248
Practice Address - Street 1:504 RED HILL AVE
Practice Address - Street 2:
Practice Address - City:SAN ANSELMO
Practice Address - State:CA
Practice Address - Zip Code:94960-2409
Practice Address - Country:US
Practice Address - Phone:415-569-3990
Practice Address - Fax:415-787-7248
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-27
Last Update Date:2022-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAND-960175F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175F00000XOther Service ProvidersNaturopath