LISA GAY FREDRICKSON FNP
NPI 1932533924
Nurse Practitioner - Family in Fort Bragg, CA

Q: What is Lisa Fredrickson's NPI number?

The NPI number for Lisa Fredrickson is 1932533924. It was assigned to this individual provider in the NPPES registry on August 26, 2013.

Q: What is Lisa Fredrickson's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Family, with taxonomy code 363LF0000X.

Q: When was this NPI record last updated?

The NPPES record for Lisa Fredrickson was last updated on November 18, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.

Active since August 26, 2013PECOS Enrolled

205 SOUTH ST, FORT BRAGG, CA 95437(707) 961-1251 Get Directions Write a Review

NPPES record last updated: November 18, 2023. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Nov 18, 2023, Aug 21, 2023, Mar 10, 2023 (3 updates tracked since 2023).

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About Lisa Gay Fredrickson Fnp NPPES

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

LISA GAY FREDRICKSON FNP (NPI 1932533924) is an individual family provider in Fort Bragg, California, licensed in California (95026356) and active in the NPI registry since August 2013. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1932533924

Entity TypeIndividualFemale

Primary Taxonomy363LF0000X

Provider Legal NameLISA GAY FREDRICKSONCredential: FNP

Location Address205 SOUTH STFort Bragg, CA 95437-5540

Mailing Address860 E Laurel StFort Bragg, CA 95437-3817 · (707) 972-0884

Phone(707) 961-1251

Sole ProprietorNo

Enumeration DateAugust 26, 2013

Last NPPES UpdateNovember 18, 20233 updates tracked since enumeration

NPPES CertifiedNovember 18, 2023

✔ NPI 1932533924 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyNurse Practitioner · FamilyPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363LF0000X

License✔ Licensed in CA · 95026356

Also ListedRegistered NurseTaxonomy 163W00000X · License 806740 (CA)

205 SOUTH ST, Fort Bragg, CA 95437

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Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Lisa Gay Fredrickson Fnp is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 95437 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient

$90.32 typical visit price

range $58.87 – $176.60

Typical copayment $22.58 (range $14.71 – $44.15)

Most-billed visit code 99203

Established Patient

$103.36 typical visit price

range $19.28 – $144.60

Typical copayment $25.84 (range $4.82 – $36.15)

Most-billed visit code 99214

Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

MR. RICHARD WILLIAM JAULUS LCSW

Social Worker (Clinical)