Individual provider Active NPI

Robert Curtis Krueger, PH.D.

  • Clinical Psychologist
  • Lancaster, CA
National Provider Identifier
1174606255
Registry record updated Jun 17, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
PSY19602 Issued in CA
Practice address
2064 W Avenue J
Suite 385
Lancaster, CA 93536-5913
Phone
(661) 435-1058
Fax
(661) 793-7480
NPI assigned
Oct 23, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 17, 2013

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X PSY19602 CA Primary

Addresses

Primary practice location

2064 W Avenue J
Suite 385
Lancaster, CA 93536-5913

Mailing address

2064 W Avenue J
Suite 385
Lancaster, CA 93536-5913
Phone (661) 435-1058

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050328000813 CA Practitioner - Clinical Psychologist 7911953484 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Pacific Heritage Medical Group IncGroup PAC ID 7517284029, 62 clinicians

Practice addresses (Care Compare)

3625 E Thousand Oaks Blvd
Suite 232
Westlake Village, CA 91362-6932
Phone (818) 518-9715

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
PSY19602CAMDClinical Psychologist
19602CAMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Inland Psychiatric Medical Group, Inc. CurrentSince Dec 2, 2019 Accepting new patients
Pacific Heritage Medical Group Inc CurrentSince Oct 1, 2022 Accepting new patients
Asana Integrated Medical Group PC Clinical CurrentSince Jan 6, 2020 Accepting new patients
Inland Psychiatric Medical Group, Inc. Clinical CurrentSince Dec 2, 2019 Accepting new patients

Locations

300 W Huntington Dr
Arcadia, CA 91007
Phone (626) 445-4441

16279 Walnut St
Hesperia, CA 92345
Phone (760) 243-7700

24432 Muirlands Blvd
Ste 131
Lake Forest, CA 92630
Phone (714) 520-3000

1656 W Avenue J
Lancaster, CA 93534
Phone (661) 942-1169

1600 W Avenue J
Lancaster, CA 93534
Phone (661) 726-6254

8710 Monroe Ct
Ste 150
Rancho Cucamonga, CA 91730
Phone (909) 941-4870

1809 W Redlands Blvd
Redlands, CA 92373
Phone (909) 307-1320

2101 N Waterman Ave
Sn Bernrdno, CA 92404
Phone (909) 881-4305

1805 Medical Center Dr
Sn Bernrdno, CA 92411
Phone (909) 877-6333

3625 E Thousand Oaks Blvd
Ste 232
Westlake Village, CA 91362
Phone (818) 518-9715

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1161561600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1371427200000",
    "number": "1174606255",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2064 W AVENUE J",
            "address_2": "SUITE 385",
            "city": "LANCASTER",
            "state": "CA",
            "postal_code": "935365913",
            "telephone_number": "661-435-1058",
            "fax_number": "661-793-7480"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2064 W AVENUE J",
            "address_2": "SUITE 385",
            "city": "LANCASTER",
            "state": "CA",
            "postal_code": "935365913",
            "telephone_number": "661-435-1058",
            "fax_number": "661-793-7480"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KRUEGER",
        "first_name": "ROBERT",
        "middle_name": "CURTIS",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-23",
        "last_updated": "2013-06-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CA",
            "license": "PSY19602",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lancaster, CA

Sources for this page

Verify at the official NPI Registry.