MEDICARE: MISS PERRI ALEXANDRA KRUSE

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	1041C0700X	Clinical Social Worker	95073	CA

General Provider Information

NPI Number	:	1336574789
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MISS PERRI ALEXANDRA KRUSE

Provider Business Mailing Address
First Line	:	5767 W CENTURY BLVD
Second Line	:	SUITE 400
City	:	LOS ANGELES
State	:	CA
Zip	:	90095-5631
Country	:	US
Telephone Number	:	310-301-8836
Fax Number	:

Provider Business Practice Location Address
First Line	:	100 UCLA MEDICAL PLAZA
Second Line	:	SUITE 205
City	:	LOS ANGELES
State	:	CA
Zip	:	90095-6999
Country	:	US
Telephone Number	:	310-208-5400
Fax Number	:

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

Provider Enumeration Date	:	09/04/2013
Last Update Date	:	04/27/2026

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