YELENA KRUSE (NPI# 1417320573) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1417320573 |
| Entity Type | Individual |
| Full Name | YELENA KRUSE |
| Credential | AGCNS-BC |
| Practice Address |
99 Montecillo Rd San Rafael CA 94903-3308 |
| Practice Telephone | 4154442349 |
| Mailing Telephone | 4154442349 |
| Enumeration Date | 2015-11-10 |
| Last Update Date | 2016-02-12 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 364SG0600X |
Clinical Nurse Specialist Specialization: Gerontology |
4370 | CA | Physician Assistants & Advanced Practice Nursing Providers |
| N | 364SX0200X |
Clinical Nurse Specialist Specialization: Oncology |
4370 | CA | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
99 MONTECILLO RD |
| City | SAN RAFAEL |
| State | CA |
| Zip Code | 94903-3308 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1174528889 | Jeffry D Cardneau | Surgery | 99 Montecillo Rd, Mob 1, 2nd Floor, Department of Surgery, San Rafael, CA 94903-3308 | 2005-06-17 |
| 1225645468 | Lauren Freudman | Occupational Therapist | 99 Montecillo Rd, San Rafael, CA 94903-3308 | 2020-09-30 |
| 1285254037 | Omar Ahmed | Pharmacist | 99 Montecillo Rd, San Rafael, CA 94903-3308 | 2020-04-22 |
| 1447887229 | Meka Angela Parks | Registered Nurse | 99 Montecillo Rd, San Rafael, CA 94903-3308 | 2020-03-24 |
| 1710519202 | Mahsa Khorramdin | Pharmacist | 99 Montecillo Rd, San Rafael, CA 94903-3308 | 2020-02-12 |
| 1568001071 | Jessica Tan | Pharmacist | 99 Montecillo Rd, San Rafael, CA 94903-3308 | 2019-12-31 |
| 1720626211 | Ava May Mahan | Pharmacist | 99 Montecillo Rd, San Rafael, CA 94903-3308 | 2019-12-15 |
| 1437797271 | Alicia Pontecorvo | Dietitian, Registered | 99 Montecillo Rd, San Rafael, CA 94903-3308 | 2019-12-11 |
| 1437795499 | Shirley Liu | Pharmacist | 99 Montecillo Rd, San Rafael, CA 94903-3308 | 2019-11-25 |
| 1831740422 | Natalie Marie Vano | Nurse Practitioner | 99 Montecillo Rd, San Rafael, CA 94903-3308 | 2019-09-25 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1467089524 | Christopher Sazo | Counselor | 1 St. Vincents Drive, San Rafael, CA 94903 | 2020-03-26 |
| 1134769482 | Katherine Sieger | Music Therapist | 400 Civic Center Dr. #300, San Rafael, CA 94903 | 2020-01-14 |
| 1679064836 | California In Home Care & Registry, Inc | In Home Supportive Care | 14b Mitchell Blvd, Suite B, San Rafael, CA 94903 | 2018-05-23 |
| 1922557586 | Helen Elizabeth Shamis | Marriage & Family Therapist | 30 North San Pedro, Suite #265, Beyond Hunger, San Rafael, CA 94903 | 2016-09-23 |
| 1033572771 | Henry Colbert | Counselor | 1 St. St. Vincent Drive, San Rafael, CA 94903 | 2016-03-31 |
| 1659736924 | Robyn Bloom | Marriage & Family Therapist | 4 Joseph Court, San Rafael, CA 94903 | 2015-12-30 |
| 1851760565 | Cheryl Clementson | Substance Abuse Rehabilitation Facility | 301 Smith Ranch Road, San Rafael, CA 94903 | 2015-09-23 |
| 1588043731 | Chelsea Cooney | Counselor | 1 St. Vincent's Drive, San Rafael, CA 94903 | 2015-05-20 |
| 1083002315 | Kaiser Permanente | Psychiatric Unit | 111 Smith Ranch Road, Kaiser Permanente, San Rafael, CA 94903 | 2015-01-09 |
| 1366857856 | Travel Well Corporation | Preventive Medicine | 28 Mitchell Blvd, San Rafael, CA 94903 | 2014-06-24 |
| Find all providers in zip 94903 | ||||
| Taxonomy Code | 364SG0600X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Clinical Nurse Specialist |
| Specialization | Gerontology |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1780212993 | Jacqueline Fitzgerald Close I | Clinical Nurse Specialist | 11188 Carlota St, San Diego, CA 92129-1212 | 2020-04-01 |
| 1891339602 | Darryl De Los Angeles | Clinical Nurse Specialist | 8016 Paso Robles Ave, Lake Balboa, CA 91406-1124 | 2019-11-05 |
| 1841704921 | Juliet Li-yeh Shih | Clinical Nurse Specialist | 4131 Geary Blvd # 402, San Francisco, CA 94118-3101 | 2017-11-27 |
| 1235597352 | Edna Culp | Clinical Nurse Specialist | 14562 High Pine St, Poway, CA 92064-5918 | 2016-02-03 |
| 1457756413 | Ann M. Mayo | Clinical Nurse Specialist | 806 Vanitie Ct, San Diego, CA 92109-7038 | 2014-11-01 |
| 1467727313 | Catherine Caston | Clinical Nurse Specialist | 412 N Bellflower Blvd, Unit # 312, Long Beach, CA 90814-2055 | 2012-03-11 |
| 1689730590 | Karen Sheng | Clinical Nurse Specialist | 901 Marshall St, Redwood City, CA 94063-2026 | 2006-12-28 |
| 1851455372 | Charles Wayne Williams | Clinical Nurse Specialist | 5040 Brabant Ct, Elk Grove, CA 95757-3295 | 2006-12-20 |
| 1275146870 | Mary Katharine Salas | Clinical Nurse Specialist | 4501 Sand Creek Rd, Antioch, CA 94531-8687 | 2020-08-25 |
| 1881238780 | Maria Nerina Girasol | Clinical Nurse Specialist | 28202 Cabot Rd, Laguna Niguel, CA 92677-1222 | 2019-11-04 |
| Find all providers with the same taxonomy | ||||
| City | SAN RAFAEL |
| Zip Code | 94903 |
Please comment or provide details below to improve the information on YELENA KRUSE.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.