Provider Demographics
NPI:1598880528
Name:GRAMLING, S. ELIZABETH (MA)
Entity Type:Individual
Prefix:MS
First Name:S. ELIZABETH
Middle Name:
Last Name:GRAMLING
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:37 AUBURN AVE STE 1
Mailing Address - Street 2:
Mailing Address - City:SIERRA MADRE
Mailing Address - State:CA
Mailing Address - Zip Code:91024-1846
Mailing Address - Country:US
Mailing Address - Phone:626-833-0309
Mailing Address - Fax:
Practice Address - Street 1:37 AUBURN AVE STE 1
Practice Address - Street 2:
Practice Address - City:SIERRA MADRE
Practice Address - State:CA
Practice Address - Zip Code:91024-1846
Practice Address - Country:US
Practice Address - Phone:626-833-0309
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-20
Last Update Date:2013-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA20065106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist