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Individual

DR. KIM S FREDERICKSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MD

Contact information

Practice address
400 PROFESSIONAL CENTER DRIVE, SUITE 414 NOVATO DERMATOLOGY ASSOCIATES, NOVATO, CA 94947
(415) 892-0754
(415) 897-3204
Mailing address
400 PROFESSIONAL CENTER DRIVE, SUITE 414, NOVATO, CA 94947
(415) 892-0754
(415) 897-3204

Taxonomy

Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
G79619
CA

Other

Enumeration date
11/06/2006
Last updated
10/10/2008
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