Healthcare Provider Details

I. General information

NPI: 1750278065
Provider Name (Legal Business Name): CHRISTINE KRUEGER PPS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/19/2025
Last Update Date: 06/19/2025
Certification Date: 06/19/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1010 N MAIN ST
SANTA ANA CA
92701-3602
US

IV. Provider business mailing address

6791 LAFAYETTE DR
HUNTINGTON BEACH CA
92647-4045
US

V. Phone/Fax

Practice location:
  • Phone: 714-560-0900
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YS0200X
TaxonomySchool Counselor
License Number220044567
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: