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MR. JUSTIN WILLIAM FREDERICKSEN LPN
NPI 1982082400
Licensed Psychiatric Technician in Eureka, CA

Active since May 16, 2015

NPPES record last updated: May 2, 2021. Verified against the NPPES registry weekly; last sync: August 23, 2026.

About Mr. Justin William Fredericksen Lpn NPPES

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

MR. JUSTIN WILLIAM FREDERICKSEN LPN (NPI 1982082400) is an individual licensed psychiatric technician in Eureka, California and active in the NPI registry since May 2015.

NPPES Registry Identity

NPI1982082400
Entity TypeIndividualMale
Primary Taxonomy167G00000X
Provider Legal NameMR. JUSTIN WILLIAM FREDERICKSENCredential: LPN
Location Address720 WOOD STEureka, CA 95501-4413
Mailing Address720 Wood StEureka, CA 95501-4413 · (707) 268-2994
Phone(707) 268-2994
Sole ProprietorNo
Enumeration DateMay 16, 2015
Last NPPES UpdateMay 2, 2021
NPPES CertifiedMay 2, 2021
✔ NPI 1982082400 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyLicensed Psychiatric TechnicianNursing Service Providers
Taxonomy Code167G00000X
Definition
An individual licensed by the state board as a Psychiatric Technician based upon completion of a prescribed course of theory and clinical practice, with two thirds of the clinical practice time focused on mental and developmental disorders. The psychiatric technician practices under the direct supervision of a physician, psychologist, registered nurse or other professional to provide care to patients with mental disorders and developmental disabilities.
Also ListedLicensed Practical NurseTaxonomy 164W00000X · License LPN15722 (NV)
720 WOOD ST, Eureka, CA 95501
Open in Google Maps ↗

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.

MISS ASHLEY DAWN KINMAN
Case Manager/Care Coordinator
720 WOOD ST
EUREKA, CA 95501
Humboldt County (707) 268-2990
JACQUELYN WHITE
Counselor (Mental Health)
720 WOOD ST
EUREKA, CA 95501
Humboldt County (707) 268-2990
SHAWNA RECKINGER RN
Registered Nurse (Psychiatric/Mental Health)
720 WOOD ST
EUREKA, CA 95501
Humboldt County (707) 268-2990
ALLISON JUDY PHILLIPS RN
Registered Nurse (Psychiatric/Mental Health)
720 WOOD ST
EUREKA, CA 95501
Humboldt County (707) 268-2990
AIMEE LEEANNE WOODS LVN
Licensed Vocational Nurse
720 WOOD ST
EUREKA, CA 95501
Humboldt County (707) 268-2990
ERIC CARL VEDBORG LMFT
Marriage & Family Therapist
720 WOOD ST
EUREKA, CA 95501
Humboldt County (707) 268-2935
MS. LESLIE ANN PETERSEN
Registered Nurse
720 WOOD ST, HUMBOLDT COUNTY MENTAL HEALTH
EUREKA, CA 95501
Humboldt County (707) 445-7710
BARBARA MARY FRANKLIN RN
Registered Nurse (Psychiatric/Mental Health)
720 WOOD ST
EUREKA, CA 95501
Humboldt County (707) 445-7710

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Justin Fredericksen's NPI number?

The NPI number for Justin Fredericksen is 1982082400. It was assigned to this individual provider in the NPPES registry on May 16, 2015.

Where is Justin Fredericksen located?

Justin Fredericksen practices at 720 Wood St, Eureka, CA 95501. The listed phone number is (707) 268-2994.

What is Justin Fredericksen's specialty?

The primary specialty registered for this NPI is Licensed Psychiatric Technician with taxonomy code 167G00000X.

When was this NPI record last updated?

The NPPES record for Justin Fredericksen was last updated on May 2, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 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.