Provider Demographics
NPI:1649211996
Name:KRAUSZ, MARJORIE VEGO (EDD, MFT)
Entity Type:Individual
Prefix:DR
First Name:MARJORIE
Middle Name:VEGO
Last Name:KRAUSZ
Suffix:
Gender:F
Credentials:EDD, MFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6994 EL CAMINO REAL STE 205B
Mailing Address - Street 2:
Mailing Address - City:CARLSBAD
Mailing Address - State:CA
Mailing Address - Zip Code:92009-4153
Mailing Address - Country:US
Mailing Address - Phone:760-931-9333
Mailing Address - Fax:760-436-5216
Practice Address - Street 1:6994 EL CAMINO REAL STE 205B
Practice Address - Street 2:
Practice Address - City:CARLSBAD
Practice Address - State:CA
Practice Address - Zip Code:92009-4153
Practice Address - Country:US
Practice Address - Phone:760-931-9333
Practice Address - Fax:760-436-5216
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-09
Last Update Date:2011-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX22132103TC1900X
CAMFT9347106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
No103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounseling
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA330841578OtherEMPLOYER ID