Provider Demographics
NPI:1902226632
Name:KRUER-ZERHUSEN, ADRIANE ELIZABETH (PSYD)
Entity Type:Individual
Prefix:DR
First Name:ADRIANE
Middle Name:ELIZABETH
Last Name:KRUER-ZERHUSEN
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:608 N AVENUE 50
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90042-3292
Mailing Address - Country:US
Mailing Address - Phone:323-897-1018
Mailing Address - Fax:
Practice Address - Street 1:608 N AVENUE 50
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90042-3292
Practice Address - Country:US
Practice Address - Phone:323-897-1018
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-04-21
Last Update Date:2024-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA28654103T00000X
103TC2200X
CAPSY28654103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
No103T00000XBehavioral Health & Social Service ProvidersPsychologist
No103TC2200XBehavioral Health & Social Service ProvidersPsychologistClinical Child & Adolescent
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN3984OtherSTATE LICENSE