Provider Demographics
NPI:1942485107
Name:KRUGER, ELSABE AMELIA (OTR/L; CSI; CPAM)
Entity Type:Individual
Prefix:MRS
First Name:ELSABE
Middle Name:AMELIA
Last Name:KRUGER
Suffix:
Gender:F
Credentials:OTR/L; CSI; CPAM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7413 N CEDAR AVE
Mailing Address - Street 2:SUITE 102
Mailing Address - City:FRESNO
Mailing Address - State:CA
Mailing Address - Zip Code:93720-3833
Mailing Address - Country:US
Mailing Address - Phone:559-449-1557
Mailing Address - Fax:559-297-4428
Practice Address - Street 1:7413 N CEDAR AVE
Practice Address - Street 2:SUITE 102
Practice Address - City:FRESNO
Practice Address - State:CA
Practice Address - Zip Code:93720
Practice Address - Country:US
Practice Address - Phone:559-449-1557
Practice Address - Fax:559-297-4428
Is Sole Proprietor?:Yes
Enumeration Date:2008-01-07
Last Update Date:2009-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
225XN1300X
CAOT00002288225XP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatrics
No225XN1300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistNeurorehabilitation