Healthcare Provider Details

I. General information

NPI: 1518106533
Provider Name (Legal Business Name): LEILA ANN KRAMER PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/13/2009
Last Update Date: 09/22/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2025 SOQUEL AVE.
SANTA CRUZ CA
95065-1794
US

IV. Provider business mailing address

2025 SOQUEL AVE. PALO ALTO MEDICAL FOUNDATION, URGENT CARE
SANTA CRUZ CA
95065-1794
US

V. Phone/Fax

Practice location:
  • Phone: 831-458-5537
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number20195
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: