Healthcare Provider Details

I. General information

NPI: 1770889628
Provider Name (Legal Business Name): KRISTEN SHELENA KRAUEL-PRIVETT LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: KRISTEN KRAUEL LCSW

II. Dates (important events)

Enumeration Date: 02/09/2011
Last Update Date: 09/23/2026
Certification Date: 09/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11985 HERITAGE OAK PL STE 100
AUBURN CA
95603-2413
US

IV. Provider business mailing address

2021 FILLMORE ST STE 208
SAN FRANCISCO CA
94115-2708
US

V. Phone/Fax

Practice location:
  • Phone: 530-889-4954
  • Fax:
Mailing address:
  • Phone: 415-933-7312
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberLPCC1201
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number StateCA
# 3
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State
# 4
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberLCSW27259
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: