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Mr. Kevin Jerome Frederick
Rehabilitation Practitioner in Long Beach, California
NPI 1366878068

Kevin Jerome Frederick is a Rehabilitation Practitioner based in Long Beach, CA. Kevin Jerome Frederick practices in Long Beach, CA. The NPI Number for Kevin Jerome Frederick is 1366878068 and holds a License No. (California).

The current practice location address for Kevin Jerome Frederick is 1501 Hughes Way, Long Beach, CA and can be reached out via phone at 310-221-6336.

Location: 1501 Hughes Way, Long Beach, CA, 90810-1876
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1366878068
Provider Name
Kevin Jerome Frederick
Credential
Provider Entity Type
Individual
Gender
Male
Address
1501 Hughes Way, Long Beach, CA, 90810-1876
Phone Number
310-221-6336
Fax Number
Provider Enumeration Date
09/25/2013
Last Update Date
03/09/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
225400000X 01 CA RAHABILITATION PARCTITIONER
institution
Provider Business Practice Location Address Details
Address
1501 Hughes Way
City
Long Beach
State
California
Zip
90810-1876
Phone Number
310-221-6336
Fax Number
person
Provider Business Mailing Address Details
Address
1501 Hughes Way
City
Long Beach
State
California
Zip
90810-1876
Phone Number
310-221-6336
Fax Number
person
Provider's Taxonomy Details 1
Type
Respiratory, Developmental, Rehabilitative and Restorative Service Providers
Classification
Rehabilitation Practitioner
Speciality
-
Taxonomy
225400000X
License No.
()
Definition
A health care practitioner who trains or retrains individuals disabled by disease or injury to help them attain their maximum functional capacity.
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