Provider Demographics
NPI:1124706783
Name:KRAUS, MARCEL (ASSOCIATE MFT)
Entity type:Individual
Prefix:MR
First Name:MARCEL
Middle Name:
Last Name:KRAUS
Suffix:
Gender:M
Credentials:ASSOCIATE MFT
Other - Prefix:
Other - First Name:MARC
Other - Middle Name:ADAM
Other - Last Name:KRAUS
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:
Mailing Address - Street 1:7826 TOPANGA CANYON BLVD APT 209
Mailing Address - Street 2:
Mailing Address - City:CANOGA PARK
Mailing Address - State:CA
Mailing Address - Zip Code:91304-5586
Mailing Address - Country:US
Mailing Address - Phone:310-745-6120
Mailing Address - Fax:
Practice Address - Street 1:300 S BEVERLY DR STE 203
Practice Address - Street 2:
Practice Address - City:BEVERLY HILLS
Practice Address - State:CA
Practice Address - Zip Code:90212-4805
Practice Address - Country:US
Practice Address - Phone:323-667-6215
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-07-05
Last Update Date:2023-07-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA130047106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist