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

Mr. Ryan Timothy Fredricks, CRNA

Individual provider Registered Nurse · NPI 1962057034

Mr. Ryan Timothy Fredricks, CRNA is a Certified Registered Nurse Anesthetist (CRNA) in Gilroy, California. Qualified in 2021, 5 years ago. Practices with Permanente Medical Group Inc, a 10,941-clinician group and accepts Medicare assignment. Licensed in California.

Years since qualifying
5
Licensed in
CA
In the registry since
2019
Specialties on file
2
What do these letters mean?
CRNA — Certified Registered Nurse Anesthetist
An advanced practice nurse who administers anaesthesia.

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Practice location Address checks out

9170 Jacaranda Way
Gilroy, CA 95020-7417
Phone: (408) 607-0263
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Certified Registered Nurse Anesthetist (primary) Taxonomy 367500000X · Licence 95001662 (CA)
Registered Nurse Taxonomy 163W00000X · Licence 95135050 (CA)

Record details

NPI number1962057034
Entity typeIndividual (Type 1)
GenderMale
Credentials CRNA
Sole proprietorYes
NPI enumeratedAugust 6, 2019
Last updated in NPPESApril 8, 2023
Certification dateApril 8, 2023
Mailing address9170 Jacaranda Way, Gilroy, CA 95020-7417

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyCERTIFIED REGISTERED NURSE ANESTHETIST (CRNA)
Medical schoolOTHER
Graduated 2021 (5 years in practice)
Group practice Permanente Medical Group Inc — 10941 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations2 on file with Medicare

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