Provider Demographics
NPI:1255471454
Name:KRAUSE, NAOMI RUTH (LPC, RAS)
Entity Type:Individual
Prefix:
First Name:NAOMI
Middle Name:RUTH
Last Name:KRAUSE
Suffix:
Gender:F
Credentials:LPC, RAS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3707 SUNSET LN
Mailing Address - Street 2:
Mailing Address - City:ANTIOCH
Mailing Address - State:CA
Mailing Address - Zip Code:94509-6101
Mailing Address - Country:US
Mailing Address - Phone:925-522-0124
Mailing Address - Fax:925-522-0133
Practice Address - Street 1:3707 SUNSET LN
Practice Address - Street 2:
Practice Address - City:ANTIOCH
Practice Address - State:CA
Practice Address - Zip Code:94509-6101
Practice Address - Country:US
Practice Address - Phone:925-522-0124
Practice Address - Fax:925-522-0133
Is Sole Proprietor?:No
Enumeration Date:2007-02-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAK0412181611101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)