Provider Demographics
NPI:1881014900
Name:KREBS, KORY
Entity Type:Individual
Prefix:
First Name:KORY
Middle Name:
Last Name:KREBS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2605 WILLOWBROOK LN UNIT 36
Mailing Address - Street 2:
Mailing Address - City:APTOS
Mailing Address - State:CA
Mailing Address - Zip Code:95003-6017
Mailing Address - Country:US
Mailing Address - Phone:209-985-6832
Mailing Address - Fax:
Practice Address - Street 1:2605 WILLOWBROOK LN UNIT 36
Practice Address - Street 2:
Practice Address - City:APTOS
Practice Address - State:CA
Practice Address - Zip Code:95003-6017
Practice Address - Country:US
Practice Address - Phone:209-985-6832
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-04-16
Last Update Date:2014-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical