Provider Demographics
NPI:1134241680
Name:KRAMER, ANN PULTZ (MFT)
Entity type:Individual
Prefix:MS
First Name:ANN
Middle Name:PULTZ
Last Name:KRAMER
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 1:11455 SUMMER GREEN CT
Mailing Address - Street 2:
Mailing Address - City:MORENO VALLEY
Mailing Address - State:CA
Mailing Address - Zip Code:92557-8314
Mailing Address - Country:US
Mailing Address - Phone:951-781-9080
Mailing Address - Fax:951-653-4009
Practice Address - Street 1:13800 HEACOCK ST STE C212
Practice Address - Street 2:
Practice Address - City:MORENO VALLEY
Practice Address - State:CA
Practice Address - Zip Code:92553-6266
Practice Address - Country:US
Practice Address - Phone:951-653-4001
Practice Address - Fax:951-653-4009
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFC25106106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist