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General NPI Number Information
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NPI Number | 1093462541
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Entity Type | Individual
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Provider Name | JOSHUA SIMON KRAUSE MA, LMFT
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Gender | Male
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Dates
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Enumeration Date | 03/04/2022
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Last Update Date | 03/04/2022
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Provider Practice Location Address
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Address Line | 7183 NAVAJO RD STE B
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City | SAN DIEGO
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State | CA
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Zip | 92119-1650
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Country | US
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Telephone | 619-813-2096
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Fax |
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Provider Business Mailing Address
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Address Line | 8521 ROACH DR
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City | LA MESA
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State | CA
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Zip | 91942-9517
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Country | US
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Telephone | 619-871-9601
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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 | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | 131452
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License Number State | CA
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