Provider Demographics
NPI:1053491985
Name:CAMERON, CAROLYN ANKENY (RN, MFT)
Entity Type:Individual
Prefix:MS
First Name:CAROLYN
Middle Name:ANKENY
Last Name:CAMERON
Suffix:
Gender:F
Credentials:RN, MFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1430 EAST AVE
Mailing Address - Street 2:4A
Mailing Address - City:CHICO
Mailing Address - State:CA
Mailing Address - Zip Code:95926-1628
Mailing Address - Country:US
Mailing Address - Phone:530-345-3386
Mailing Address - Fax:
Practice Address - Street 1:1430 EAST AVE
Practice Address - Street 2:4A
Practice Address - City:CHICO
Practice Address - State:CA
Practice Address - Zip Code:95926-1628
Practice Address - Country:US
Practice Address - Phone:530-345-3386
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA8138106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist