Provider Demographics
NPI:1386700458
Name:KRAUS, TERRI BRUSSEAU (MPT, CCET)
Entity type:Individual
Prefix:MS
First Name:TERRI
Middle Name:BRUSSEAU
Last Name:KRAUS
Suffix:
Gender:F
Credentials:MPT, CCET
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3222 GREY HAWK COURT
Mailing Address - Street 2:
Mailing Address - City:CARLSBAD
Mailing Address - State:CA
Mailing Address - Zip Code:92010
Mailing Address - Country:US
Mailing Address - Phone:760-727-9100
Mailing Address - Fax:760-727-9122
Practice Address - Street 1:3222 GREY HAWK COURT
Practice Address - Street 2:
Practice Address - City:CARLSBAD
Practice Address - State:CA
Practice Address - Zip Code:92010
Practice Address - Country:US
Practice Address - Phone:760-727-9100
Practice Address - Fax:760-727-9122
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-30
Last Update Date:2019-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPT22367225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist