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NPI Code Detail

MEDICARE: MS. STEFENEE DIONNE CAMARENO-CLINTON MSW

MEDICARE: MS. STEFENEE DIONNE CAMARENO-CLINTON MSW
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
11041C0700XClinical Social Worker29859CA

General Provider Information

NPI Number : 1801015680
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. STEFENEE DIONNE CAMARENO-CLINTON MSW
Provider Business Mailing Address
First Line : 1212 N CALIFORNIA ST
Second Line :
City : STOCKTON
State : CA
Zip : 95202-1552
Country : US
Telephone Number : 209-468-8481
Fax Number :
Provider Business Practice Location Address
First Line : 3161 DWIGHT RD
Second Line :
City : ELK GROVE
State : CA
Zip : 95758-6456
Country : US
Telephone Number : 916-427-7141
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/24/2007
Last Update Date : 12/19/2023

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