MEDICARE: DR. ROBERT CURTIS KRUEGER PH.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	103TC0700X	Clinical Psychologist	PSY19602	CA

General Provider Information

NPI Number	:	1174606255
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ROBERT CURTIS KRUEGER PH.D.

Provider Business Mailing Address
First Line	:	2064 W AVENUE J
Second Line	:	SUITE 385
City	:	LANCASTER
State	:	CA
Zip	:	93536-5913
Country	:	US
Telephone Number	:	661-435-1058
Fax Number	:	661-793-7480

Provider Business Practice Location Address
First Line	:	2064 W AVENUE J
Second Line	:	SUITE 385
City	:	LANCASTER
State	:	CA
Zip	:	93536-5913
Country	:	US
Telephone Number	:	661-435-1058
Fax Number	:	661-793-7480

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/23/2006
Last Update Date	:	06/17/2013

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