Provider Demographics
NPI:1467323345
Name:KRUEGER, KRISTIE (AMFT)
Entity type:Individual
Prefix:
First Name:KRISTIE
Middle Name:
Last Name:KRUEGER
Suffix:
Gender:F
Credentials:AMFT
Other - Prefix:
Other - First Name:KAY
Other - Middle Name:
Other - Last Name:KRUEGER
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:AMFT
Mailing Address - Street 1:PO BOX 55461
Mailing Address - Street 2:
Mailing Address - City:VALENCIA
Mailing Address - State:CA
Mailing Address - Zip Code:91385-0461
Mailing Address - Country:US
Mailing Address - Phone:323-628-4393
Mailing Address - Fax:
Practice Address - Street 1:200 E DEL MAR BLVD STE 160
Practice Address - Street 2:
Practice Address - City:PASADENA
Practice Address - State:CA
Practice Address - Zip Code:91105-2507
Practice Address - Country:US
Practice Address - Phone:323-628-4393
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-09-15
Last Update Date:2025-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA157922106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist