=====================================================
General NPI Number Information
=====================================================
NPI Number | 1073907739
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | SUMMIT NEUROPSYCHOLOGY, PLLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 03/20/2015
-----------------------------------------------------
Last Update Date | 04/15/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 5605 RIGGINS CT STE 104
-----------------------------------------------------
City | RENO
-----------------------------------------------------
State | NV
-----------------------------------------------------
Zip | 89502-6575
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 775-525-1347
-----------------------------------------------------
Fax | 775-201-9457
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 5605 RIGGINS CT STE 104
-----------------------------------------------------
City | RENO
-----------------------------------------------------
State | NV
-----------------------------------------------------
Zip | 89502-6575
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 775-525-1347
-----------------------------------------------------
Fax | 775-201-9457
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | OWNER
-----------------------------------------------------
Name | DR. ALEX CRAMOND
-----------------------------------------------------
Credential | PHD
-----------------------------------------------------
Telephone | 775-525-1347
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 103G00000X
-----------------------------------------------------
Taxonomy Name | Clinical Neuropsychologist
-----------------------------------------------------
License Number | PY0723
-----------------------------------------------------
License Number State | NV
-----------------------------------------------------