MEDICARE: JESSICA KRAMER

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	363AS0400X	Surgical Physician Assistant

General Provider Information

NPI Number	:	1790239770
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JESSICA KRAMER

Provider Business Mailing Address
First Line	:	4250 COLDWATER CANYON AVE APT 208
Second Line	:
City	:	STUDIO CITY
State	:	CA
Zip	:	91604-1938
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	3959 LAUREL CANYON BLVD STE F
Second Line	:
City	:	STUDIO CITY
State	:	CA
Zip	:	91604-3711
Country	:	US
Telephone Number	:	818-505-9300
Fax Number	:

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

Provider Enumeration Date	:	08/08/2016
Last Update Date	:	10/17/2025

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