Provider Demographics
NPI:1508992702
Name:KRAMER, SHELDON Z (PHD)
Entity Type:Individual
Prefix:DR
First Name:SHELDON
Middle Name:Z
Last Name:KRAMER
Suffix:
Gender:M
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:PO BOX 927828
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92192-7828
Mailing Address - Country:US
Mailing Address - Phone:619-291-4465
Mailing Address - Fax:619-460-3990
Practice Address - Street 1:7777 ALVARADO RD
Practice Address - Street 2:STE 282
Practice Address - City:LA MESA
Practice Address - State:CA
Practice Address - Zip Code:91941-3616
Practice Address - Country:US
Practice Address - Phone:619-291-4465
Practice Address - Fax:619-460-3990
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY9994103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
CACP9994Medicare ID - Type UnspecifiedPPIN