Provider Demographics
NPI:1386537199
Name:BRAMER, ANITA
Entity type:Individual
Prefix:
First Name:ANITA
Middle Name:
Last Name:BRAMER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9669 GOLD COAST DR APT 87
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92126-3950
Mailing Address - Country:US
Mailing Address - Phone:310-703-7982
Mailing Address - Fax:
Practice Address - Street 1:18985 HIGHWAY 94
Practice Address - Street 2:
Practice Address - City:DULZURA
Practice Address - State:CA
Practice Address - Zip Code:91917-1527
Practice Address - Country:US
Practice Address - Phone:619-669-3295
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-05-30
Last Update Date:2025-05-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
R1505590523101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)