Provider Demographics
NPI:1215243720
Name:CRAMER, SHAWN CORY (MS CCC)
Entity type:Individual
Prefix:MRS
First Name:SHAWN
Middle Name:CORY
Last Name:CRAMER
Suffix:
Gender:F
Credentials:MS CCC
Other - Prefix:
Other - First Name:SHAWN
Other - Middle Name:CORY
Other - Last Name:DESANTO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MS CCC
Mailing Address - Street 1:480 TABOR DR.
Mailing Address - Street 2:
Mailing Address - City:SCOTTS VALLEY
Mailing Address - State:CA
Mailing Address - Zip Code:95066-2845
Mailing Address - Country:US
Mailing Address - Phone:831-246-2335
Mailing Address - Fax:
Practice Address - Street 1:480 TABOR DR.
Practice Address - Street 2:
Practice Address - City:SCOTTS VALLEY
Practice Address - State:CA
Practice Address - Zip Code:95066-2845
Practice Address - Country:US
Practice Address - Phone:831-246-2335
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-08-20
Last Update Date:2012-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CASP 12852235Z00000X
CASP12852235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist