Provider Demographics
NPI:1548096654
Name:KRAMER, JACOB DANIEL
Entity type:Individual
Prefix:
First Name:JACOB
Middle Name:DANIEL
Last Name:KRAMER
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:37 MOUNTAIN DR
Mailing Address - Street 2:
Mailing Address - City:SANTA BARBARA
Mailing Address - State:CA
Mailing Address - Zip Code:93103-1734
Mailing Address - Country:US
Mailing Address - Phone:805-363-0773
Mailing Address - Fax:
Practice Address - Street 1:37 MOUNTAIN DR
Practice Address - Street 2:
Practice Address - City:SANTA BARBARA
Practice Address - State:CA
Practice Address - Zip Code:93103-1734
Practice Address - Country:US
Practice Address - Phone:805-363-0773
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-09-13
Last Update Date:2024-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172V00000XOther Service ProvidersCommunity Health Worker