Provider Demographics
NPI:1699376368
Name:KRAUSE, JAMIE L (LMFT)
Entity Type:Individual
Prefix:
First Name:JAMIE
Middle Name:L
Last Name:KRAUSE
Suffix:
Gender:F
Credentials:LMFT
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 7454
Mailing Address - Street 2:
Mailing Address - City:BURBANK
Mailing Address - State:CA
Mailing Address - Zip Code:91510-7454
Mailing Address - Country:US
Mailing Address - Phone:424-442-0037
Mailing Address - Fax:
Practice Address - Street 1:1911 N BUENA VISTA ST UNIT 423
Practice Address - Street 2:
Practice Address - City:BURBANK
Practice Address - State:CA
Practice Address - Zip Code:91504-3396
Practice Address - Country:US
Practice Address - Phone:424-442-0037
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-11-07
Last Update Date:2024-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA121130106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist