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General NPI Number Information
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NPI Number | 1528099496
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Entity Type | Individual
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Provider Name | EMILY KERAM M.D.
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Gender | Female
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Dates
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Enumeration Date | 07/06/2006
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Last Update Date | 02/13/2021
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Provider Practice Location Address
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Address Line | 3841 BRICKWAY BLVD
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City | SANTA ROSA
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State | CA
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Zip | 95403-8226
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Country | US
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Telephone | 707-569-2300
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 6654
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City | SANTA ROSA
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State | CA
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Zip | 95406-0654
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Country | US
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Telephone | 707-494-4742
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | A049929
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License Number State | CA
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