Breeana Lee Fredricksen

Speech-Language Assistant · Stockton, CA

Individual Active NPI

NPI number 1154140036

Practice location

17986 Copperopolis Rd
Stockton, CA 95215-9717
Phone
(208) 993-3469

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NPI record

NPI
1154140036
Entity type
Individual (Type 1)
Enumeration date
October 7, 2024
Last updated
May 21, 2026
Certified
May 21, 2026
Sole proprietor
Yes

Specialties & taxonomy codes

TaxonomyCodeLicenseState
Speech-Language Assistant Primary 2355S0801X SPA8402 CA

About Breeana Fredricksen

Breeana Lee Fredricksen is a healthcare provider registered in the NPI registry with the primary taxonomy Speech-Language Assistant (code 2355S0801X). The practice location is 17986 Copperopolis Rd, Stockton, CA 95215-9717. The NPI number 1154140036 was assigned on October 7, 2024 and the record was last updated on May 21, 2026.

Breeana Fredricksen lists a license in the registry: #SPA8402 (CA) for Speech-Language Assistant. License numbers are self-reported to NPPES; verify them with the state licensing board.

Frequently asked questions

What is the NPI number of Breeana Lee Fredricksen?

The NPI number is 1154140036.

What is the phone number of Breeana Fredricksen?

The phone number listed for the practice location is (208) 993-3469.

Where is Breeana Fredricksen located?

17986 Copperopolis Rd, Stockton, CA 95215-9717.

What is the taxonomy code for Breeana Fredricksen?

The primary taxonomy code is 2355S0801X – Speech-Language Assistant.

Is this information correct?

All details come from the public NPPES registry. Providers can update their record at nppes.cms.hhs.gov; changes appear here after the next weekly update.

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