Provider Demographics
NPI:1356849269
Name:KRAUSE, TRACY REENA
Entity Type:Individual
Prefix:MISS
First Name:TRACY
Middle Name:REENA
Last Name:KRAUSE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1000
Mailing Address - Street 2:
Mailing Address - City:BAKERSFIELD
Mailing Address - State:CA
Mailing Address - Zip Code:93302-1000
Mailing Address - Country:US
Mailing Address - Phone:661-868-6601
Mailing Address - Fax:661-861-1020
Practice Address - Street 1:2621 OSWELL ST STE 119
Practice Address - Street 2:
Practice Address - City:BAKERSFIELD
Practice Address - State:CA
Practice Address - Zip Code:93306-3172
Practice Address - Country:US
Practice Address - Phone:661-868-6751
Practice Address - Fax:661-872-3001
Is Sole Proprietor?:No
Enumeration Date:2018-01-25
Last Update Date:2018-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator