Provider Demographics
NPI:1669675617
Name:KRAUSS, MARJORIE ANN
Entity Type:Individual
Prefix:MRS
First Name:MARJORIE
Middle Name:ANN
Last Name:KRAUSS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:MARJORIE
Other - Middle Name:ANN
Other - Last Name:HILL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN, CNS,MFT
Mailing Address - Street 1:PO BOX 27790
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90027-0790
Mailing Address - Country:US
Mailing Address - Phone:323-221-3400
Mailing Address - Fax:
Practice Address - Street 1:12254 BELLFLOWER BLVD
Practice Address - Street 2:SUITE 105
Practice Address - City:DOWNEY
Practice Address - State:CA
Practice Address - Zip Code:90242-2804
Practice Address - Country:US
Practice Address - Phone:800-900-3277
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFC 16952302R00000X
CARN 224379302R00000X
CACNS302R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes302R00000XManaged Care OrganizationsHealth Maintenance Organization