Provider Demographics
NPI:1093462541
Name:KRAUSE, JOSHUA SIMON (MA, LMFT)
Entity Type:Individual
Prefix:MR
First Name:JOSHUA
Middle Name:SIMON
Last Name:KRAUSE
Suffix:
Gender:M
Credentials:MA, LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8521 ROACH DR
Mailing Address - Street 2:
Mailing Address - City:LA MESA
Mailing Address - State:CA
Mailing Address - Zip Code:91942-9517
Mailing Address - Country:US
Mailing Address - Phone:619-871-9601
Mailing Address - Fax:
Practice Address - Street 1:7183 NAVAJO RD STE B
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92119-1650
Practice Address - Country:US
Practice Address - Phone:619-813-2096
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-03-04
Last Update Date:2022-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA131452106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist