Healthcare Provider Details

I. General information

NPI: 1932329042
Provider Name (Legal Business Name): NATASHA KRUSE M.A.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/30/2007
Last Update Date: 08/19/2026
Certification Date: 08/19/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2145 BILBERRY AVE
TOPANGA CA
90290-3400
US

IV. Provider business mailing address

5016 W 119TH PL
HAWTHORNE CA
90250-2715
US

V. Phone/Fax

Practice location:
  • Phone: 310-995-2628
  • Fax:
Mailing address:
  • Phone: 310-995-2628
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License NumberPSY22661
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: