Provider Demographics
NPI:1588806467
Name:KRAUSE, ANDREA LOUISE (OTR/L)
Entity type:Individual
Prefix:MRS
First Name:ANDREA
Middle Name:LOUISE
Last Name:KRAUSE
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:30 HILLER CT
Mailing Address - Street 2:
Mailing Address - City:WOODLAND
Mailing Address - State:CA
Mailing Address - Zip Code:95776-5106
Mailing Address - Country:US
Mailing Address - Phone:530-406-1778
Mailing Address - Fax:
Practice Address - Street 1:96 W MAIN ST
Practice Address - Street 2:SUITE B
Practice Address - City:WOODLAND
Practice Address - State:CA
Practice Address - Zip Code:95695-3016
Practice Address - Country:US
Practice Address - Phone:530-668-1010
Practice Address - Fax:530-668-9799
Is Sole Proprietor?:Yes
Enumeration Date:2009-03-24
Last Update Date:2009-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAOT423225XP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatrics