Healthcare Provider Details

I. General information

NPI: 1528981156
Provider Name (Legal Business Name): DEVON CAMILLE PALMER
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: DEVON CAMILLE HAYDEN

II. Dates (important events)

Enumeration Date: 07/31/2026
Last Update Date: 07/31/2026
Certification Date: 07/31/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5272 ROBERT J MATHEWS PKWY STE 110
EL DORADO HILLS CA
95762-5705
US

IV. Provider business mailing address

5272 ROBERT J MATHEWS PKWY STE 110
EL DORADO HILLS CA
95762-5705
US

V. Phone/Fax

Practice location:
  • Phone: 279-206-0446
  • Fax:
Mailing address:
  • Phone: 279-206-0446
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code246Z00000X
TaxonomyOther Specialist/Technologist
License NumberL10175
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: