MEDICARE: JACQUELINE NOA-CAMERON 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	5256	HI

General Provider Information

NPI Number	:	1487522157
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JACQUELINE NOA-CAMERON LCSW

Provider Business Mailing Address
First Line	:	PO BOX 11057
Second Line	:
City	:	HONOLULU
State	:	HI
Zip	:	96828-0057
Country	:	US
Telephone Number	:	808-204-4664
Fax Number	:

Provider Business Practice Location Address
First Line	:	4856 E EHA WAY APT A
Second Line	:
City	:	EWA BEACH
State	:	HI
Zip	:	96706-3012
Country	:	US
Telephone Number	:	808-204-4664
Fax Number	:	808-818-8486

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

Provider Enumeration Date	:	10/25/2025
Last Update Date	:	11/18/2025

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