Provider Demographics
NPI:1356752000
Name:HAWKINS, FREDRIK C
Entity type:Individual
Prefix:
First Name:FREDRIK
Middle Name:C
Last Name:HAWKINS
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8512 MADISON AVE
Mailing Address - Street 2:
Mailing Address - City:FAIR OAKS
Mailing Address - State:CA
Mailing Address - Zip Code:95628-3809
Mailing Address - Country:US
Mailing Address - Phone:916-966-4327
Mailing Address - Fax:916-966-4328
Practice Address - Street 1:8512 MADISON AVE
Practice Address - Street 2:
Practice Address - City:FAIR OAKS
Practice Address - State:CA
Practice Address - Zip Code:95628-3809
Practice Address - Country:US
Practice Address - Phone:916-966-4327
Practice Address - Fax:916-966-4328
Is Sole Proprietor?:No
Enumeration Date:2014-05-15
Last Update Date:2020-12-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAHA 3639237700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument Specialist