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DR. RANDI FREDRICKS PHD
NPI 1679889794
Marriage & Family Therapist in San Jose, CA

Active since August 26, 2010
1174 LINCOLN AVE STE 6, SAN JOSE, CA 95125(408) 315-0645 Get Directions Write a Review

NPPES record last updated: July 1, 2011. Verified against the NPPES registry weekly; last sync: July 19, 2026.

About Dr. Randi Fredricks Phd NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DR. RANDI FREDRICKS PHD (NPI 1679889794) is an individual marriage & family therapist in San Jose, California, licensed in California (47803) and active in the NPI registry since August 2010.

NPPES Registry Identity

NPI1679889794
Entity TypeIndividualFemale
Primary Taxonomy106H00000X
Provider Legal NameDR. RANDI FREDRICKSCredential: PHD
Location Address1174 LINCOLN AVE STE 6San Jose, CA 95125-3029
Mailing AddressPo Box 8252San Jose, CA 95155-8252 · (408) 315-0645
Phone(408) 315-0645
Sole ProprietorYes
Enumeration DateAugust 26, 2010
Last NPPES UpdateJuly 1, 2011
✔ NPI 1679889794 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyMarriage & Family TherapistBehavioral Health & Social Service Providers
Taxonomy Code106H00000X
License✔ Licensed in CA · 47803
Definition

A marriage and family therapist is a person with a master's degree in marriage and family therapy, or a master's or doctoral degree in a related mental health field with substantially equivalent coursework in marriage and family therapy, who receives supervised clinical experience, or a person who meets the state requirements to practice as a marriage and family therapist. A marriage and family therapist treats mental and emotional disorders within the context of marriage and family systems. A marriage and family therapist provides mental health and counseling services to individuals, couples, families, and groups.

1174 LINCOLN AVE STE 6, San Jose, CA 95125
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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

ⓘ

Opted out of Medicare

Dr. Randi Fredricks Phd has filed a Medicare opt-out affidavit. Services are provided under private contract between the provider and the patient, and are not billed to or reimbursed by Medicare. The opt-out is on file from April 1, 2024 through April 1, 2026.

Opt-Out Effective DateApril 1, 2024
Opt-Out In Effect ThroughApril 1, 2026Opt-out affidavits renew automatically every two years unless cancelled

Frequently Asked Questions

What is Randi Fredricks's NPI number?

The NPI number assigned to this healthcare provider is 1679889794, enumerated as an "individual" on August 26, 2010.

Where is the provider located?

The provider is located at 1174 LINCOLN AVE STE 6 SAN JOSE, CA 95125 and the phone number is (408) 315-0645.

What is the provider's specialty?

Marriage & Family Therapist with taxonomy code 106H00000X.