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MATILDE FREDRICKSON DO NPI 1770011348


NPI Information

NPI: 1770011348
Provider Name: MATILDE FREDRICKSON, DO
Classification: Family Medicine - 207QA0401X
Entity Type: Individual

Specialization: Addiction Medicine

PECOS Registration: Yes

Address:
1411 E 31ST ST
OAKLAND, CA
ZIP 94602
Phone: (510) 437-5039
Get Directions

Matilde Fredrickson, DO is an addiction medicine family medicine in Oakland, CA with 7 years of experience. The provider is a family medicine physician who specializes in the diagnosis and treatment of addictions. Matilde Fredrickson, DO NPI is 1770011348. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

Education
Medical School: UNIVERSITY OF NORTH TEXAS HSC, COLLEGE OF OSTEOPATHIC MED
Graduation Year:2017

The provider's business location address is:

1411 E 31ST ST
OAKLAND, CA
ZIP 94602-018
Phone: (510) 437-5039

The NPI 1770011348 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 5/26/2017 and was last updated on 9/1/2021.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1207QA0401XFamily MedicineAddiction Medicine20A16704CALIFORNIAYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.