MEDICARE: CAMERON HARRISON

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	235Z00000X	Speech-Language Pathologist	37949	CA

General Provider Information

NPI Number	:	1740130145
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CAMERON HARRISON

Provider Business Mailing Address
First Line	:	612 RED BUD LN
Second Line	:
City	:	MEADOW VISTA
State	:	CA
Zip	:	95722-9706
Country	:	US
Telephone Number	:	530-913-5266
Fax Number	:

Provider Business Practice Location Address
First Line	:	7926 FIRESTONE WAY
Second Line	:
City	:	ANTELOPE
State	:	CA
Zip	:	95843-4633
Country	:	US
Telephone Number	:	916-727-7400
Fax Number	:

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

Provider Enumeration Date	:	02/03/2026
Last Update Date	:	02/03/2026

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Directions to “ CAMERON HARRISON ” Practice Location

Language	Start Address	Practice Location

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