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General NPI Number Information
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NPI Number | 1063926467
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Entity Type | Individual
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Provider Name | FAITH MARGARET KRUEGER CADC-I
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Gender | Female
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Dates
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Enumeration Date | 11/21/2017
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Last Update Date | 11/21/2017
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Provider Practice Location Address
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Address Line | 433 TURK ST
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City | SAN FRANCISCO
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State | CA
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Zip | 94102-3329
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Country | US
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Telephone | 415-928-7800
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Fax |
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Provider Business Mailing Address
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Address Line | 143 PORTLAND DR
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City | SANTA MARIA
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State | CA
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Zip | 93458-9035
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Country | US
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Telephone | 402-547-9279
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number | CI07840617
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License Number State | CA
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