Doctor Name: | DR. LORRAINE F CAMENZULI, PH.D. |
NPI Number: | 1104232602 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | PH.D. |
License Number: | PSY10846 |
Business Practice Address: | 1337 Camino Del Mar Del Mar, CA - 920142504 |
Business Phone Number: | 8186328152 |
Business Fax Number: | |
Mailing Address: | Po Box 250, SOLANA BEACH |
State: | CA |
Postal Code: | 920750250 |
Phone Number: | 8186328152 |
Fax Number: | |
NPI Enumeration Date: | 07/03/2014 |
NPI Last Update Date: | 07/03/2014 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 103TC0700X |
License Number: | PSY10846 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | CA |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Psychologist |
Taxonomy Specialization: | Clinical |
Taxonomy Definition: |