MEDICARE: DR. SHELLEY CHERNOFF KRAMER PHD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	103TC0700X	Clinical Psychologist	PSY4219	CA

General Provider Information

NPI Number	:	1124149224
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. SHELLEY CHERNOFF KRAMER PHD

Provider Business Mailing Address
First Line	:	2181 S EL CAMINO REAL STE 305
Second Line	:
City	:	OCEANSIDE
State	:	CA
Zip	:	92054-6288
Country	:	US
Telephone Number	:	760-966-1286
Fax Number	:	760-966-1911

Provider Business Practice Location Address
First Line	:	2181 S EL CAMINO REAL STE 305
Second Line	:
City	:	OCEANSIDE
State	:	CA
Zip	:	92054-6288
Country	:	US
Telephone Number	:	760-966-1286
Fax Number	:	760-966-1911

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/03/2007
Last Update Date	:	01/29/2009

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