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General NPI Number Information
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NPI Number | 1841595485
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Entity Type | Individual
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Provider Name | KATHLEEN KRUEGER HHP
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Gender | Female
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Dates
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Enumeration Date | 01/12/2011
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Last Update Date | 01/12/2011
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Provider Practice Location Address
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Address Line | 616 S EL CAMINO REAL STE B4
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City | SAN CLEMENTE
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State | CA
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Zip | 92672-4272
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Country | US
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Telephone | 949-498-0120
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Fax |
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Provider Business Mailing Address
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Address Line | 616 S EL CAMINO REAL STE B4
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City | SAN CLEMENTE
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State | CA
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Zip | 92672-4272
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Country | US
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Telephone | 949-498-0120
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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 | 172M00000X
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Taxonomy Name | Mechanotherapist
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License Number | 5457
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 225700000X
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Taxonomy Name | Massage Therapist
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License Number | 5457
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License Number State | CA
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Taxonomy #3
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Taxonomy Code | 374J00000X
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Taxonomy Name | Doula
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 374U00000X
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Taxonomy Name | Home Health Aide
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License Number |
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License Number State |
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