Provider Demographics
NPI:1376298844
Name:KRUSER, KATHERINE (PSYD)
Entity Type:Individual
Prefix:
First Name:KATHERINE
Middle Name:
Last Name:KRUSER
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3550 WATT AVE STE 180
Mailing Address - Street 2:
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95821-2698
Mailing Address - Country:US
Mailing Address - Phone:916-955-1800
Mailing Address - Fax:
Practice Address - Street 1:3550 WATT AVE STE 180
Practice Address - Street 2:
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95821-2698
Practice Address - Country:US
Practice Address - Phone:916-955-1800
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-02-14
Last Update Date:2022-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY31971103G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103G00000XBehavioral Health & Social Service ProvidersClinical NeuropsychologistGroup - Single Specialty