MEDICARE: LAUREN KARLIE KRUEGER

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	34467	CA
2	235Z00000X	Speech-Language Pathologist	SLP16486	AZ

General Provider Information

NPI Number	:	1538657333
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LAUREN KARLIE KRUEGER

Provider Business Mailing Address
First Line	:	6215 FERRIS SQ
Second Line	:
City	:	SAN DIEGO
State	:	CA
Zip	:	92121-3283
Country	:	US
Telephone Number	:	702-622-6393
Fax Number	:

Provider Business Practice Location Address
First Line	:	6215 FERRIS SQ
Second Line	:
City	:	SAN DIEGO
State	:	CA
Zip	:	92121-3283
Country	:	US
Telephone Number	:	619-693-6598
Fax Number	:

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

Provider Enumeration Date	:	04/26/2018
Last Update Date	:	07/17/2025

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Directions to “ LAUREN KARLIE KRUEGER ” Practice Location

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