MEDICARE: JAMAL RASHAD CAMERON LMFT

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	106H00000X	Marriage & Family Therapist	133473	CA

General Provider Information

NPI Number	:	1134593551
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JAMAL RASHAD CAMERON LMFT

Provider Business Mailing Address
First Line	:	1450 10TH ST STE 404
Second Line	:
City	:	SANTA MONICA
State	:	CA
Zip	:	90401-2831
Country	:	US
Telephone Number	:	925-282-1778
Fax Number	:

Provider Business Practice Location Address
First Line	:	1450 10TH ST STE 404
Second Line	:
City	:	SANTA MONICA
State	:	CA
Zip	:	90401-2831
Country	:	US
Telephone Number	:	925-282-1778
Fax Number	:

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

Provider Enumeration Date	:	11/23/2015
Last Update Date	:	03/18/2026

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