Organization Active NPI

Shelley Chernoff Kramer, PH.D., Inc., Clinical Psychology

  • Clinical Psychologist
  • Oceanside, CA
National Provider Identifier
1174643035
Registry record updated Jul 13, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
PSY4219 Issued in CA
Legal business name
SHELLEY CHERNOFF KRAMER, PH.D., INC., CLINICAL PSYCHOLOGY
Practice address
2181 S El Camino Real
Ste 305
Oceanside, CA 92054-6288
Phone
(760) 966-1286
Fax
(760) 966-1911
NPI assigned
Apr 1, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2012

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

Authorized official

Name
Dr. Shelley Kramer, PHDNPI 1124149224
Title
Psychologist
Phone
(760) 966-1286

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical PsychologistGroup: 193400000X SINGLE SPECIALTY GROUP 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
Suite 305
Oceanside, CA 92054-6220
Phone (760) 966-1286

Other identifiers 1

IdentifierTypeStateIssuer
CP4219AOtherCAMEDICARE PTAN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20120717000304 CA Part B Supplier - Clinic/Group Practice 8729244991 Receives reassigned benefits from 1 practitioner
Practice locations: Oceanside, CA; San Diego, CA

National Provider Directory

National Provider Directory

Locations

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

3356 2nd Ave
Ste E
San Diego, CA 92103
Phone (619) 295-2045

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

Practitioners & affiliated clinicians

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1175385600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1342137600000",
    "number": "1174643035",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2181 S EL CAMINO REAL",
            "address_2": "SUITE 305",
            "city": "OCEANSIDE",
            "state": "CA",
            "postal_code": "920546220",
            "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",
            "address_2": "STE 305",
            "city": "OCEANSIDE",
            "state": "CA",
            "postal_code": "920546288",
            "telephone_number": "760-966-1286",
            "fax_number": "760-966-1911"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SHELLEY CHERNOFF KRAMER, PH.D., INC., CLINICAL PSYCHOLOGY",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-01",
        "last_updated": "2012-07-13",
        "status": "A",
        "authorized_official_last_name": "KRAMER",
        "authorized_official_first_name": "SHELLEY",
        "authorized_official_title_or_position": "PSYCHOLOGIST",
        "authorized_official_telephone_number": "760-966-1286",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PHD"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychologist, Clinical",
            "state": "CA",
            "license": "PSY4219",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "CP4219A",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Oceanside, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.