Healthcare Provider Details

I. General information

NPI: 1568361541
Provider Name (Legal Business Name): CHELSEA CAMILLE CAMPBELL
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/04/2026
Last Update Date: 11/04/2026
Certification Date: 11/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

41594 MARGARITA RD APT 192
TEMECULA CA
92591-2924
US

IV. Provider business mailing address

41594 MARGARITA RD APT 192
TEMECULA CA
92591-2924
US

V. Phone/Fax

Practice location:
  • Phone: 530-762-9032
  • Fax:
Mailing address:
  • Phone: 530-762-9032
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: