| Organization Name: | CAMERON PARK COUNSELING CENTER |
| NPI Number: | 1093104325 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | MARIA NIETO (DIRECTOR) |
| Mailing Address: | 3294 Royal Dr Ste 13 Cameron Park |
| State: | CA US |
| Postal Code: | 956828500 |
| Phone Number: | 5306774404 |
| Fax Number: | 5306774545 |
| NPI Enumeration Date: | 01/09/2015 |
| NPI Last Update Date: | 01/09/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 305S00000X |
| License Number: | PSY 6138 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | CA |
| Taxonomy Type: | Managed Care Organizations |
| Taxonomy Classification: | Point of Service |
| Taxonomy Specialization: | |
| Taxonomy Definition: | This product may also be called an open-ended HMO and offers a transition product incorporating features of both HMOs and PPOs. Beneficiaries are enrolled in an HMO but have the option to go outside the networks for an additional cost. |