Provider Demographics
NPI:1669685657
Name:CRAMER, GAIL HOUSTON (MFT)
Entity Type:Individual
Prefix:MS
First Name:GAIL
Middle Name:HOUSTON
Last Name:CRAMER
Suffix:
Gender:F
Credentials:MFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:555 HOSPITAL LN
Mailing Address - Street 2:
Mailing Address - City:SUSANVILLE
Mailing Address - State:CA
Mailing Address - Zip Code:96130-4918
Mailing Address - Country:US
Mailing Address - Phone:530-251-8108
Mailing Address - Fax:
Practice Address - Street 1:555 HOSPITAL LANE
Practice Address - Street 2:
Practice Address - City:SUSNANVILLE
Practice Address - State:CA
Practice Address - Zip Code:96130
Practice Address - Country:US
Practice Address - Phone:530-251-8108
Practice Address - Fax:530-251-8394
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-07
Last Update Date:2010-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFC 45427106H00000X, 101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA1801Medicaid