Individual provider Active NPI

Shelley Chernoff Kramer, PHD

  • Clinical Psychologist
  • Oceanside, CA
National Provider Identifier
1124149224
Registry record updated Jan 29, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
PSY4219 Issued in CA
Practice address
2181 S El Camino Real Ste 305
Oceanside, CA 92054-6288
Phone
(760) 966-1286
Fax
(760) 966-1911
NPI assigned
Apr 3, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 29, 2009

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X PSY4219 CA Primary

Addresses

Primary practice location

2181 S El Camino Real Ste 305
Oceanside, CA 92054-6288

Mailing address

2181 S El Camino Real Ste 305
Oceanside, CA 92054-6288
Phone (760) 966-1286

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120717000336 CA Practitioner - Clinical Psychologist 9436315603 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 1971
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

2181 S El Camino Real
Suite 305
Oceanside, CA 92054-6288
Phone (760) 966-1286

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
4219CAMDNurse Massage Therapist (NMT)

Practice roles

OrganizationSpecialtyStatusNew patients
Shelley Chernoff Kramer, PH.D., Inc., Clinical Psychology Clinical CurrentSince Feb 5, 1985 Accepting new patients

Locations

2181 S El Camino Real
Ste 305
Oceanside, CA 92054
Phone 760224442217

3368 2nd Ave
Ste A3
San Diego, CA 92103
Phone (619) 297-0515

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1175558400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1233187200000",
    "number": "1124149224",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2181 S EL CAMINO REAL STE 305",
            "city": "OCEANSIDE",
            "state": "CA",
            "postal_code": "920546288",
            "telephone_number": "760-966-1286",
            "fax_number": "760-966-1911"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2181 S EL CAMINO REAL STE 305",
            "city": "OCEANSIDE",
            "state": "CA",
            "postal_code": "920546288",
            "telephone_number": "760-966-1286",
            "fax_number": "760-966-1911"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KRAMER",
        "first_name": "SHELLEY",
        "middle_name": "CHERNOFF",
        "name_prefix": "Dr.",
        "credential": "PHD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-04-03",
        "last_updated": "2009-01-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CA",
            "license": "PSY4219",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Oceanside, CA

Sources for this page

Verify at the official NPI Registry.