Provider Demographics
NPI:1083947485
Name:REYES CAMARILLO, MARIA DEL CARMEN
Entity Type:Individual
Prefix:MS
First Name:MARIA
Middle Name:DEL CARMEN
Last Name:REYES CAMARILLO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:MARIA
Other - Middle Name:DEL CARMEN
Other - Last Name:REYES VELASQUEZ
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:4333 E VINEYARD AVE
Mailing Address - Street 2:
Mailing Address - City:OXNARD
Mailing Address - State:CA
Mailing Address - Zip Code:93036-1013
Mailing Address - Country:US
Mailing Address - Phone:805-981-5578
Mailing Address - Fax:805-981-5674
Practice Address - Street 1:4333 E VINEYARD AVE
Practice Address - Street 2:
Practice Address - City:OXNARD
Practice Address - State:CA
Practice Address - Zip Code:93036-1013
Practice Address - Country:US
Practice Address - Phone:805-981-5578
Practice Address - Fax:805-981-5674
Is Sole Proprietor?:No
Enumeration Date:2009-09-16
Last Update Date:2013-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101YM0800X
CA284151041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health