Provider Demographics
NPI:1558584466
Name:KRAMER, RENEE H (NP)
Entity Type:Individual
Prefix:
First Name:RENEE
Middle Name:H
Last Name:KRAMER
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1901 N CALIFORNIA ST
Mailing Address - Street 2:
Mailing Address - City:STOCKTON
Mailing Address - State:CA
Mailing Address - Zip Code:95204-6005
Mailing Address - Country:US
Mailing Address - Phone:209-946-6800
Mailing Address - Fax:209-946-6805
Practice Address - Street 1:1901 N CALIFORNIA ST
Practice Address - Street 2:
Practice Address - City:STOCKTON
Practice Address - State:CA
Practice Address - Zip Code:95204-6005
Practice Address - Country:US
Practice Address - Phone:209-946-6800
Practice Address - Fax:209-946-6805
Is Sole Proprietor?:No
Enumeration Date:2007-04-10
Last Update Date:2014-07-22
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CA9171363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAS97378Medicare UPIN