George Edgar Kruse IV

Primary specialty

Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X

License

CI07300317 Issued in CA

Practice address

720 Wood St
Eureka, CA 95501-4413

Phone

(707) 268-2990

NPI assigned

Dec 20, 2017

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1513728000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1516320000000",
    "number": "1972019362",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2245 PARKWOOD BLVD",
            "city": "EUREKA",
            "state": "CA",
            "postal_code": "955037042"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "720 WOOD ST",
            "city": "EUREKA",
            "state": "CA",
            "postal_code": "955014413",
            "telephone_number": "707-268-2990"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KRUSE",
        "first_name": "GEORGE",
        "middle_name": "EDGAR",
        "name_suffix": "IV",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-12-20",
        "last_updated": "2018-01-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "CA",
            "license": "CI07300317",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Larissa Krause, MSW, ASW
• Thomas F Krenek IV, MD
• Zora Bernice Kreutzer
• Todd Krider, B.A.
• Nicole Marie Kriger
• Vail Krygsman
• Joseph Siegfried Krzesni, LMFT
• Kukhwa Ryu DDS Inc
• Marissa Louise Kummerling, MD, MPH
• John Christopher Kurylo, MD

• Addiction (Substance Use Disorder) Counselor in Eureka, CA
• Providers in Eureka, CA by specialty
• Addiction (Substance Use Disorder) Counselor in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 19, 2018; 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.