MEDICARE: MRS. ELLEN STEIN KRAMER LCSW

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	1041C0700X	Clinical Social Worker	16767	CA

General Provider Information

NPI Number	:	1639486129
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. ELLEN STEIN KRAMER LCSW

Provider Business Mailing Address
First Line	:	3107 LAMA AVE
Second Line	:
City	:	LONG BEACH
State	:	CA
Zip	:	90808-3238
Country	:	US
Telephone Number	:	562-596-0600
Fax Number	:

Provider Business Practice Location Address
First Line	:	3107 LAMA AVE
Second Line	:
City	:	LONG BEACH
State	:	CA
Zip	:	90808-3238
Country	:	US
Telephone Number	:	562-596-0600
Fax Number	:

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

Provider Enumeration Date	:	09/07/2010
Last Update Date	:	09/07/2010

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