Provider Demographics
NPI:1649481979
Name:SCHRAMM, SUSAN J (MSW)
Entity type:Individual
Prefix:MS
First Name:SUSAN
Middle Name:J
Last Name:SCHRAMM
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:421 HUMBOLDT ST
Mailing Address - Street 2:
Mailing Address - City:SANTA ROSA
Mailing Address - State:CA
Mailing Address - Zip Code:95404-4214
Mailing Address - Country:US
Mailing Address - Phone:707-526-1994
Mailing Address - Fax:707-576-7490
Practice Address - Street 1:421 HUMBOLDT ST
Practice Address - Street 2:
Practice Address - City:SANTA ROSA
Practice Address - State:CA
Practice Address - Zip Code:95404-4214
Practice Address - Country:US
Practice Address - Phone:707-526-1994
Practice Address - Fax:707-576-7490
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-25
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALCS52961041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical