MEDICARE: MS. LORRI CAMERON BESSETTE LCSW

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1041C0700X	Clinical Social Worker	LCSW4244	HI

General Provider Information

NPI Number	:	1093232662
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. LORRI CAMERON BESSETTE LCSW

Provider Business Mailing Address
First Line	:	4012 EPANOW AVE
Second Line	:
City	:	SAN DIEGO
State	:	CA
Zip	:	92117-4626
Country	:	US
Telephone Number	:	808-425-8630
Fax Number	:

Provider Business Practice Location Address
First Line	:	4012 EPANOW AVE
Second Line	:
City	:	SAN DIEGO
State	:	CA
Zip	:	92117-4626
Country	:	US
Telephone Number	:	808-425-8630
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/24/2017
Last Update Date	:	12/30/2022

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