Provider Demographics
NPI:1205232535
Name:KRAUS, STEPHANIE ANNE (LMFT)
Entity Type:Individual
Prefix:
First Name:STEPHANIE
Middle Name:ANNE
Last Name:KRAUS
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:200 24TH ST.
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:CA
Mailing Address - Zip Code:94804
Mailing Address - Country:US
Mailing Address - Phone:510-412-9200
Mailing Address - Fax:510-412-9248
Practice Address - Street 1:200 24TH ST
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:CA
Practice Address - Zip Code:94804-1804
Practice Address - Country:US
Practice Address - Phone:510-412-9200
Practice Address - Fax:510-412-9248
Is Sole Proprietor?:Yes
Enumeration Date:2014-11-13
Last Update Date:2018-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAIMF82543106H00000X
CALMFT102503106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist