Provider Demographics
NPI:1457724825
Name:TRAMELL, SANDRA L (PHD)
Entity Type:Individual
Prefix:MRS
First Name:SANDRA
Middle Name:L
Last Name:TRAMELL
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:55 W SIERRA MADRE BLVD STE 304
Mailing Address - Street 2:
Mailing Address - City:SIERRA MADRE
Mailing Address - State:CA
Mailing Address - Zip Code:91024-3017
Mailing Address - Country:US
Mailing Address - Phone:626-355-2397
Mailing Address - Fax:
Practice Address - Street 1:55 W SIERRA MADRE BLVD STE 304
Practice Address - Street 2:
Practice Address - City:SIERRA MADRE
Practice Address - State:CA
Practice Address - Zip Code:91024-3017
Practice Address - Country:US
Practice Address - Phone:626-355-2397
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-11-07
Last Update Date:2015-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALMFT16091106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist