Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Mr. Justin William Fredericksen, LPN

Individual provider Licensed Practical Nurse · NPI 1982082400

Mr. Justin William Fredericksen, LPN is a Licensed Practical Nurse in Eureka, California. Licensed in Nevada. Registered with an NPI since 2015.

Licensed in
NV
In the registry since
2015
Specialties on file
2
What do these letters mean?
LPN — Licensed Practical Nurse
A licensed nurse who works under the direction of an RN or physician.

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Practice location Address checks out

720 Wood St
Eureka, CA 95501-4413
Phone: (707) 268-2994
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Licensed Psychiatric Technician (primary) Taxonomy 167G00000X
Licensed Practical Nurse Taxonomy 164W00000X · Licence LPN15722 (NV)

Record details

NPI number1982082400
Entity typeIndividual (Type 1)
GenderMale
Credentials LPN
Sole proprietorNo
NPI enumeratedMay 16, 2015
Last updated in NPPESMay 2, 2021
Certification dateMay 2, 2021

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