Provider Demographics
NPI:1487706511
Name:KRAMER, GINA STANWOOD (MFT)
Entity type:Individual
Prefix:MRS
First Name:GINA
Middle Name:STANWOOD
Last Name:KRAMER
Suffix:
Gender:F
Credentials:MFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1434 THIRD ST STE 3A
Mailing Address - Street 2:
Mailing Address - City:NAPA
Mailing Address - State:CA
Mailing Address - Zip Code:94559-2860
Mailing Address - Country:US
Mailing Address - Phone:707-334-4704
Mailing Address - Fax:707-258-1209
Practice Address - Street 1:1434 THIRD ST STE 3A
Practice Address - Street 2:
Practice Address - City:NAPA
Practice Address - State:CA
Practice Address - Zip Code:94559-2860
Practice Address - Country:US
Practice Address - Phone:707-334-4704
Practice Address - Fax:707-258-1209
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-17
Last Update Date:2021-12-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFC 41417106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA3221Medicare ID - Type Unspecified