Provider Demographics
NPI:1093855678
Name:CAMARILLO, CHERYL ANN (LCSW)
Entity Type:Individual
Prefix:MISS
First Name:CHERYL
Middle Name:ANN
Last Name:CAMARILLO
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:404 E RAMSEY RD
Mailing Address - Street 2:STE 210
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78216-4667
Mailing Address - Country:US
Mailing Address - Phone:210-494-1991
Mailing Address - Fax:210-494-7575
Practice Address - Street 1:404 E RAMSEY RD
Practice Address - Street 2:STE 210
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78216-4667
Practice Address - Country:US
Practice Address - Phone:210-494-1991
Practice Address - Fax:210-494-7575
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-06
Last Update Date:2017-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX260561041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical