Healthcare Provider Details

I. General information

NPI: 1558279745
Provider Name (Legal Business Name): MIEL JUAN KRAUSS OTD, OTR/L
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/31/2026
Last Update Date: 08/31/2026
Certification Date: 08/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1975 VERDUGO BLVD STE D
LA CANADA FLINTRIDGE CA
91011-3024
US

IV. Provider business mailing address

352 MYRTLE ST APT 2
GLENDALE CA
91203-2262
US

V. Phone/Fax

Practice location:
  • Phone: 818-864-6602
  • Fax:
Mailing address:
  • Phone: 808-640-4565
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code225XF0002X
TaxonomyFeeding, Eating & Swallowing Occupational Therapist
License Number28549
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code225XP0019X
TaxonomyPhysical Rehabilitation Occupational Therapist
License Number28549
License Number StateCA
# 3
Primary TaxonomyN
Taxonomy Code225XP0200X
TaxonomyPediatric Occupational Therapist
License Number28549
License Number StateCA
# 4
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number28549
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: