MEDICARE: RUTH KRIEGEL

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	235Z00000X	Speech-Language Pathologist	13116	CA

General Provider Information

NPI Number	:	1154633832
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	RUTH KRIEGEL

Provider Business Mailing Address
First Line	:	4219 BON HOMME RD
Second Line	:
City	:	CALABASAS
State	:	CA
Zip	:	91302-5104
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	19730 VENTURA BLVD STE 103B
Second Line	:
City	:	WOODLAND HILLS
State	:	CA
Zip	:	91364-2693
Country	:	US
Telephone Number	:	818-884-5103
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/09/2010
Last Update Date	:	11/28/2018

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Directions to “ RUTH KRIEGEL ” Practice Location

Language	Start Address	Practice Location

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