Provider Demographics
NPI:1538300231
Name:CROUS, LOURENS (PSYD)
Entity Type:Individual
Prefix:DR
First Name:LOURENS
Middle Name:
Last Name:CROUS
Suffix:
Gender:M
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:PO BOX 751
Mailing Address - Street 2:
Mailing Address - City:POINT ARENA
Mailing Address - State:CA
Mailing Address - Zip Code:95468-0751
Mailing Address - Country:US
Mailing Address - Phone:415-890-3911
Mailing Address - Fax:
Practice Address - Street 1:245 LAKE STREET
Practice Address - Street 2:
Practice Address - City:POINT ARENA
Practice Address - State:CA
Practice Address - Zip Code:95468
Practice Address - Country:US
Practice Address - Phone:415-890-3911
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-03-10
Last Update Date:2022-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY22518103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA11936185OtherCAQH
1538300231OtherCMS NPI NUMBER