NPIMap

Organization Active NPI

Bonnie Krueger, PH.D.

  • Clinical Psychologist
  • Los Angeles, CA
National Provider Identifier
1396941928
Registry record updated Apr 12, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
PSY16400 Issued in CA
Legal business name
BONNIE KRUEGER, PH.D.
Practice address
5015 Eagle Rock Blvd
Suite 200
Los Angeles, CA 90041-2085
Phone
(323) 356-4577
NPI assigned
Jun 21, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 12, 2012

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

Authorized official

Name
Dr. Bonnie Krueger, PH.D.NPI 1144425935
Title
Psychologist
Phone
(323) 356-4577

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical PsychologistGroup: 193400000X SINGLE SPECIALTY GROUP 103TC0700X PSY16400 CA Primary

Addresses

Primary practice location

5015 Eagle Rock Blvd
Suite 200
Los Angeles, CA 90041-2085

Mailing address

1567 Hazelwood Ave
Los Angeles, CA 90041-3315
Phone (323) 356-4577

National Provider Directory

National Provider Directory

Locations

5015 Eagle Rock Blvd
Ste 200
Los Angeles, CA 90041
Phone (323) 455-4868

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1182384000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1334188800000",
    "number": "1396941928",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1567 HAZELWOOD AVE",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900413315",
            "telephone_number": "323-356-4577"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5015 EAGLE ROCK BLVD",
            "address_2": "SUITE 200",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900412085",
            "telephone_number": "323-356-4577"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BONNIE KRUEGER, PH.D.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-06-21",
        "last_updated": "2012-04-12",
        "status": "A",
        "authorized_official_last_name": "KRUEGER",
        "authorized_official_first_name": "BONNIE",
        "authorized_official_title_or_position": "PSYCHOLOGIST",
        "authorized_official_telephone_number": "323-356-4577",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PH.D."
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychologist, Clinical",
            "state": "CA",
            "license": "PSY16400",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Angeles, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 12, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.