Provider Demographics
NPI:1801360847
Name:CLIPPER, TRAMEL
Entity Type:Individual
Prefix:
First Name:TRAMEL
Middle Name:
Last Name:CLIPPER
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1819 SAINT JAMES CT
Mailing Address - Street 2:
Mailing Address - City:LANCASTER
Mailing Address - State:CA
Mailing Address - Zip Code:93534-5101
Mailing Address - Country:US
Mailing Address - Phone:626-200-5039
Mailing Address - Fax:
Practice Address - Street 1:1819 SAINT JAMES CT
Practice Address - Street 2:
Practice Address - City:LANCASTER
Practice Address - State:CA
Practice Address - Zip Code:93534-5101
Practice Address - Country:US
Practice Address - Phone:626-200-5039
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-01-13
Last Update Date:2019-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst