Provider Demographics
NPI:1619263431
Name:ANDRUSKA, KRISTIN (MD, PHD)
Entity Type:Individual
Prefix:DR
First Name:KRISTIN
Middle Name:
Last Name:ANDRUSKA
Suffix:
Gender:F
Credentials:MD, PHD
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 391344
Mailing Address - Street 2:
Mailing Address - City:MOUNTAIN VIEW
Mailing Address - State:CA
Mailing Address - Zip Code:94039-1344
Mailing Address - Country:US
Mailing Address - Phone:650-484-0440
Mailing Address - Fax:
Practice Address - Street 1:825 POLLARD RD STE 100
Practice Address - Street 2:
Practice Address - City:LOS GATOS
Practice Address - State:CA
Practice Address - Zip Code:95032-1435
Practice Address - Country:US
Practice Address - Phone:650-484-0440
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-06-20
Last Update Date:2020-10-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA1365412084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology