Provider Demographics
NPI:1407733165
Name:KRAUSS, JONATHAN ISAAC AUSTIN SR (LPT)
Entity type:Individual
Prefix:MR
First Name:JONATHAN
Middle Name:ISAAC AUSTIN
Last Name:KRAUSS
Suffix:SR
Gender:M
Credentials:LPT
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Mailing Address - Street 1:17250 VAILETTI DR
Mailing Address - Street 2:
Mailing Address - City:SONOMA
Mailing Address - State:CA
Mailing Address - Zip Code:95476-3328
Mailing Address - Country:US
Mailing Address - Phone:951-842-1867
Mailing Address - Fax:
Practice Address - Street 1:17250 VAILETTI DR
Practice Address - Street 2:
Practice Address - City:SONOMA
Practice Address - State:CA
Practice Address - Zip Code:95476-3328
Practice Address - Country:US
Practice Address - Phone:707-989-7245
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-08-16
Last Update Date:2025-08-16
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CA36048167G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes167G00000XNursing Service ProvidersLicensed Psychiatric Technician