Individual
ANDREA JAYNE FREDERICK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
N.P
Contact information
Practice address
300 PASTEUR DR., ROOM A260, STANFORD, CA 94305-5319
(650) 724-9220
(650) 724-1444
Mailing address
234 BERESFORD AVE, REDWOOD CITY, CA 94061-3504
(650) 261-9279
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
19137
CA
Other
Enumeration date
10/08/2010
Last updated
10/08/2010
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