| Doctor Name: | DR. CHRISTINE FREDERICKS |
| NPI Number: | 1346530268 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | PH.D. |
| License Number: | PSY19931 |
| Business Practice Address: | 5901 Encina Rd Suite A Goleta, CA - 931172269 |
| Business Phone Number: | 8056810035 |
| Business Fax Number: | 8056810029 |
| Mailing Address: | 5901 Encina Rd, Suite A GOLETA |
| State: | CA |
| Postal Code: | 931172269 |
| Phone Number: | 8056810035 |
| Fax Number: | 8056810029 |
| NPI Enumeration Date: | 04/12/2011 |
| NPI Last Update Date: | 04/12/2011 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 103TC0700X |
| License Number: | PSY19931 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | CA |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Psychologist |
| Taxonomy Specialization: | Clinical |
| Taxonomy Definition: | |