Provider Demographics
NPI:1386798338
Name:KRAMER, EVELYN AGUILERA (PA)
Entity type:Individual
Prefix:
First Name:EVELYN
Middle Name:AGUILERA
Last Name:KRAMER
Suffix:
Gender:F
Credentials:PA
Other - Prefix:MS
Other - First Name:EVELYN
Other - Middle Name:A
Other - Last Name:KRAMER
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:PA
Mailing Address - Street 1:29121 W WHITESBRIDGE AVE
Mailing Address - Street 2:
Mailing Address - City:MENDOTA
Mailing Address - State:CA
Mailing Address - Zip Code:93640-9702
Mailing Address - Country:US
Mailing Address - Phone:559-903-0839
Mailing Address - Fax:
Practice Address - Street 1:992 O ST
Practice Address - Street 2:
Practice Address - City:FIREBAUGH
Practice Address - State:CA
Practice Address - Zip Code:93622-2221
Practice Address - Country:US
Practice Address - Phone:559-659-3011
Practice Address - Fax:559-659-3065
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-23
Last Update Date:2014-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPA12331363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical