Provider Demographics
NPI:1851884688
Name:KRAUSE, LARISSA (MSW, ASW)
Entity Type:Individual
Prefix:
First Name:LARISSA
Middle Name:
Last Name:KRAUSE
Suffix:
Gender:F
Credentials:MSW, ASW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2313 I ST
Mailing Address - Street 2:
Mailing Address - City:EUREKA
Mailing Address - State:CA
Mailing Address - Zip Code:95501-4244
Mailing Address - Country:US
Mailing Address - Phone:707-296-9295
Mailing Address - Fax:
Practice Address - Street 1:2313 I ST
Practice Address - Street 2:
Practice Address - City:EUREKA
Practice Address - State:CA
Practice Address - Zip Code:95501-4244
Practice Address - Country:US
Practice Address - Phone:707-296-9295
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-06-06
Last Update Date:2023-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA678211041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical