Individual provider Active NPI

Eileen M Kramer, PSY.D.

  • Clinical Psychologist
  • Dana Point, CA
National Provider Identifier
1184793119
Registry record updated Mar 17, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
PSY25548 Issued in CA
Practice address
24681 La PLZ Ste 370
Dana Point, CA 92629-2568
Phone
(949) 899-5790
Fax
(224) 365-3488
NPI assigned
Nov 6, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 17, 2018

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 PSY25548 CA Primary

Addresses

Primary practice location

24681 La PLZ Ste 370
Dana Point, CA 92629-2568

Mailing address

24681 La Plaza
Suite 370
Laguna Niguel, CA 92629-2568
Phone (949) 813-8180

Other practice location 1

34248 Via Santa Rosa
Capistrano Beach, CA 92624-1121
Phone (949) 489-8121

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
I20150319000028 CA Practitioner - Clinical Psychologist 5092032680 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

1670 Santa Ana Ave
Suite F
Costa Mesa, CA 92627-3840
Phone (949) 813-8180

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PSY25548CAMDClinical Psychologist
25548CAMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Pacific Hills Treatment Centers, Inc. Past Accepting new patients

Organizations & group practices 2

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": "1162771200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521244800000",
    "number": "1184793119",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "24681 LA PLAZA",
            "address_2": "SUITE 370",
            "city": "LAGUNA NIGUEL",
            "state": "CA",
            "postal_code": "926292568",
            "telephone_number": "949-813-8180",
            "fax_number": "224-365-3488"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "24681 LA PLZ STE 370",
            "city": "DANA POINT",
            "state": "CA",
            "postal_code": "926292568",
            "telephone_number": "949-899-5790",
            "fax_number": "224-365-3488"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "34248 Via Santa Rosa",
            "address_purpose": "LOCATION",
            "city": "Capistrano Beach",
            "state": "CA",
            "postal_code": "926241121",
            "country_code": "US",
            "telephone_number": "949-489-8121",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KRAMER",
        "first_name": "EILEEN",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "credential": "PSY.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-11-06",
        "last_updated": "2018-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CA",
            "license": "PSY25548",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dana Point, CA

Sources for this page

Verify at the official NPI Registry.