Provider Demographics
NPI:1952392755
Name:KRATZ, KRIS E (PHD, ABPP)
Entity Type:Individual
Prefix:
First Name:KRIS
Middle Name:E
Last Name:KRATZ
Suffix:
Gender:M
Credentials:PHD, ABPP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10474 W THUNDERBIRD BLVD
Mailing Address - Street 2:SUITE 200
Mailing Address - City:SUN CITY
Mailing Address - State:AZ
Mailing Address - Zip Code:85351-3023
Mailing Address - Country:US
Mailing Address - Phone:623-972-3800
Mailing Address - Fax:
Practice Address - Street 1:10494 W THUNDERBIRD BLVD
Practice Address - Street 2:SUITE 108
Practice Address - City:SUN CITY
Practice Address - State:AZ
Practice Address - Zip Code:85351-3058
Practice Address - Country:US
Practice Address - Phone:623-523-6921
Practice Address - Fax:623-583-8246
Is Sole Proprietor?:No
Enumeration Date:2005-10-31
Last Update Date:2009-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ3899103T00000X, 103G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103G00000XBehavioral Health & Social Service ProvidersClinical Neuropsychologist
No103T00000XBehavioral Health & Social Service ProvidersPsychologist