Healthcare Provider Details

I. General information

NPI: 1114778347
Provider Name (Legal Business Name): ALMA P CAMACHO
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/27/2024
Last Update Date: 03/27/2024
Certification Date: 03/27/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

125 S D ST STE 101
MADERA CA
93638-3634
US

IV. Provider business mailing address

801 CLAREMONT DR
MADERA CA
93637-2909
US

V. Phone/Fax

Practice location:
  • Phone: 559-673-8006
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: