Healthcare Provider Details

I. General information

NPI: 1245309301
Provider Name (Legal Business Name): ROSEMARIE JOY CAMERON LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/06/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5762 BOLSA AVE STE 107
HUNTINGTON BEACH CA
92649-1172
US

IV. Provider business mailing address

1203 REGGIO AISLE
IRVINE CA
92606-0855
US

V. Phone/Fax

Practice location:
  • Phone: 714-898-0362
  • Fax: 714-893-3267
Mailing address:
  • Phone: 949-933-0677
  • Fax: 949-733-1953

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number20521
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: