Healthcare Provider Details

I. General information

NPI: 1407003692
Provider Name (Legal Business Name): REBECCA KRAUS LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/19/2008
Last Update Date: 05/21/2025
Certification Date: 05/21/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2907 CLAREMONT AVE # 2
BERKELEY CA
94705-2450
US

IV. Provider business mailing address

3080 LYNDE ST
OAKLAND CA
94601-2727
US

V. Phone/Fax

Practice location:
  • Phone: 510-612-7363
  • Fax:
Mailing address:
  • Phone: 510-612-7363
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number115706
License Number StateTX
# 2
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number60022335
License Number StateWA
# 3
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number27434
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: