Independent US Healthcare Provider Directory & Public Medical Database
Deactivated NPI 1376234823 Deactivated / Inactive NPI Male Practitioner

Dr. Dane Fredericksen , PharmD

Pharmacist • Carlsbad, CA

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Notice of NPI Deactivation & Inactive Practice Status

According to official public domain records published by CMS (Centers for Medicare & Medicaid Services) in the National Provider Identifier (NPPES) Registry, Dr. Dane Fredericksen has officially deactivated this NPI record and ceased active healthcare practice.

Registration / Start Date May 16, 2023
NPI Deactivation Date April 30, 2026
Total Practice Duration ~3 Years of Practice (2023 – 2026)

Professional Overview & Biography Verified Profile Summary

Dr. Dane Fredericksen, PharmD was a registered Pharmacist practicing in Carlsbad, CA. Throughout an active medical career spanning 3 years, Dr. Fredericksen provided care at the practice location at 2510 EL CAMINO REAL until profile deactivation on 2026-04-30.

Practice Location & Contact Primary Location

Practice Address

2510 El Camino Real

Carlsbad, CA 920081273

Telephone 7607298941
Associated Practice Facility / Clinic
🏢 Garfield Beach Cvs Llc Facility NPI 1366487266

Specialty Benchmarks & Practice Insights

Comparative analytics for Pharmacist in Carlsbad, CA

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 10.5 Yrs
State Avg: 16.8 Yrs
Regional Practice Density
95 Specialists

Practicing in Carlsbad, CA (33119 Statewide)

Telehealth Adoption Rate
0.0% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount
67.4% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Medical Specialties & State Licenses

Pharmacist Primary Specialty

NUCC Taxonomy Code: 183500000X

State License CA 67972

An individual licensed by the appropriate state regulatory agency to engage in the practice of pharmacy. The practice of pharmacy includes, but is not limited to, assessment, interpretation, evaluation, and implementation, initiation, monitoring or modification of medication and or medical orders; the compounding or dispensing of medication and or medical orders; participation in drug and device procurement, storage, and selection; drug administration; drug regimen reviews; drug or drug-related research; provision of patient education and the provision of those acts or services necessary to provide medication therapy management services in all areas of patient care.

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

17 Associated Practitioners
NPI 1003289398

Bachelor of Science

Tina Thai

Pharmacist

NPI 1013389345
Dr. Daniela Shon , DNP

Nurse Practitioner - Family

NPI 1013688738

Doctor of Nursing Practice

Jazel Sambo , NP

Nurse Practitioner

NPI 1043860844

Nurse Practitioner

Son Luu

Pharmacist

NPI 1245603950
Minh Nhan

Pharmacist

NPI 1245860501

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

7 Historical Events
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NPI Profile Deactivated April 30, 2026

Record deactivated on April 30, 2026

NPI Profile Active May 16, 2023

NPI status registered as active in NPPES database

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Updated Practice Location May 16, 2023

Registered at 2510 EL CAMINO REAL, CARLSBAD, CA 920081273 (Tel: 7607298941)

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Updated Business Mailing Address May 16, 2023

Registered at 6631 WESTERN AVE, BUENA PARK, CA 906212837 (Tel: 7147577584)

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Provider Name / Credentials Updated May 16, 2023

Recorded as DANE FREDERICKSEN, PHARM. D.

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Medical Taxonomy / Specialty Registered (Primary Specialty) May 16, 2023

Pharmacist (License #67972 in CA)

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Initial NPI Registration & Enumeration May 16, 2023

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1376234823
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: May 16, 2023
Last Update: May 16, 2023
Deactivation Date: April 30, 2026

Mailing Address

6631 Western Ave

Buena Park, CA 906212837

Phone: 7147577584

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).
⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.