Organization Name: | CAMERON PARK COUNSELING CENTER |
NPI Number: | 1477760874 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | ROSE-MARIE YVONNE NIETO (CLINICAL DIRECTOR) |
Mailing Address: | 3294 Royal Dr Suite 13 Cameron Park |
State: | CA US |
Postal Code: | 956828534 |
Phone Number: | 5306774404 |
Fax Number: | 5306774545 |
NPI Enumeration Date: | 05/16/2007 |
NPI Last Update Date: | 08/17/2010 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 1041C0700X |
License Number: | LCS10219 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | CA |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Social Worker |
Taxonomy Specialization: | Clinical |
Taxonomy Definition: | A social worker who holds a master |