Healthcare Provider Details

I. General information

NPI: 1114833852
Provider Name (Legal Business Name): CAMILLE CURTIS CCC-SLP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/21/2026
Last Update Date: 08/21/2026
Certification Date: 08/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

34471 VIA ESPINOZA APT B
CAPISTRANO BEACH CA
92624-1375
US

IV. Provider business mailing address

34471 VIA ESPINOZA APT B
CAPISTRANO BEACH CA
92624-1375
US

V. Phone/Fax

Practice location:
  • Phone: 949-510-8739
  • Fax:
Mailing address:
  • Phone: 949-510-8739
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number37830
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: