Healthcare Provider Details

I. General information

NPI: 1326339128
Provider Name (Legal Business Name): ADAMINA CAMACHO M.S., B.A.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/27/2011
Last Update Date: 10/15/2024
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7600 GRAVES AVE
ROSEMEAD CA
91770-3414
US

IV. Provider business mailing address

PO BOX 905
NORCO CA
92860-0905
US

V. Phone/Fax

Practice location:
  • Phone: 626-280-6510
  • Fax: 626-288-8903
Mailing address:
  • Phone: 626-280-6510
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number92612
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: