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NPI Code Detail

MEDICARE: MIA JAMERSON

MEDICARE: MIA JAMERSON
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
1101YM0800XMental Health Counselor
2172V00000XCommunity Health Worker
3373H00000XDay Training/Habilitation Specialist

General Provider Information

NPI Number : 1144742024
Entity Type Code : Individual
Provider Name (Legal Business Name) : MIA JAMERSON
Provider Business Mailing Address
First Line : 1722 S LEWIS RD
Second Line :
City : CAMARILLO
State : CA
Zip : 93012-8520
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 751 E DAILY DR STE 320
Second Line :
City : CAMARILLO
State : CA
Zip : 93010-0772
Country : US
Telephone Number : 805-312-0424
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/12/2017
Last Update Date : 06/25/2025

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Directions to “ MIA JAMERSON ” Practice Location

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