Healthcare Provider Details

I. General information

NPI: 1699549741
Provider Name (Legal Business Name): CAMERON JAMES WERME ATC
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/09/2023
Last Update Date: 06/04/2025
Certification Date: 06/04/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

601 NEECE DR
MODESTO CA
95351-3772
US

IV. Provider business mailing address

12807 RUTH LEE CT
FORT MILL SC
29708-8003
US

V. Phone/Fax

Practice location:
  • Phone: 209-572-4487
  • Fax:
Mailing address:
  • Phone: 803-415-0421
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code2255A2300X
TaxonomyAthletic Trainer
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: