Healthcare Provider Details

I. General information

NPI: 1467112557
Provider Name (Legal Business Name): BRIDGETTE KREUZ
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/30/2021
Last Update Date: 07/16/2026
Certification Date: 07/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2001 DWIGHT WAY FL 2
BERKELEY CA
94704-2608
US

IV. Provider business mailing address

1861 GELBKE LN
CONCORD CA
94520-4029
US

V. Phone/Fax

Practice location:
  • Phone: 510-204-5248
  • Fax:
Mailing address:
  • Phone: 614-448-8124
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number27472
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: