Healthcare Provider Details

I. General information

NPI: 1255816468
Provider Name (Legal Business Name): TREMELL CRAMER
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/03/2018
Last Update Date: 05/05/2023
Certification Date: 09/07/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2001 E 4TH ST STE 116
SANTA ANA CA
92705-3916
US

IV. Provider business mailing address

2001 E 4TH ST STE 116
SANTA ANA CA
92705-3916
US

V. Phone/Fax

Practice location:
  • Phone: 714-595-5679
  • Fax:
Mailing address:
  • Phone: 714-595-5679
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberASW110160
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: