Doctor Name: | MS. CAROL LYNN CAMARILLO |
NPI Number: | 1912135807 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | PSYD |
License Number: | PSY 22641 |
Business Practice Address: | 100 Prison Rd Represa, CA - 956713000 |
Business Phone Number: | 9169858610 |
Business Fax Number: | 9162943066 |
Mailing Address: | Po Box 7211, CITRUS HEIGHTS |
State: | CA |
Postal Code: | 956217211 |
Phone Number: | 9169858610 |
Fax Number: | 9162943066 |
NPI Enumeration Date: | 06/30/2009 |
NPI Last Update Date: | 06/30/2009 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 103TF0200X |
License Number: | PSY 22641 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | CA |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Psychologist |
Taxonomy Specialization: | Forensic |
Taxonomy Definition: |