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NPI Code Detail

MEDICARE: KRISTAN ROSE KRULL

MEDICARE: KRISTAN ROSE KRULL
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
1101YM0800XMental Health Counselor20876CA

General Provider Information

NPI Number : 1649113317
Entity Type Code : Individual
Provider Name (Legal Business Name) : KRISTAN ROSE KRULL
Provider Business Mailing Address
First Line : 6850 MORRO RD
Second Line :
City : ATASCADERO
State : CA
Zip : 93422-4123
Country : US
Telephone Number : 510-317-1444
Fax Number :
Provider Business Practice Location Address
First Line : 6850 MORRO RD
Second Line :
City : ATASCADERO
State : CA
Zip : 93422-4123
Country : US
Telephone Number : 510-317-1444
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/09/2026
Last Update Date : 04/09/2026

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Directions to “ KRISTAN ROSE KRULL ” Practice Location

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