Provider Demographics
NPI:1225048432
Name:CAMPLIN, DAVID ROY (MFT)
Entity Type:Individual
Prefix:MR
First Name:DAVID
Middle Name:ROY
Last Name:CAMPLIN
Suffix:
Gender:M
Credentials:MFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8962 DAHLIA DR
Mailing Address - Street 2:
Mailing Address - City:CORONA
Mailing Address - State:CA
Mailing Address - Zip Code:92883-7101
Mailing Address - Country:US
Mailing Address - Phone:951-768-5085
Mailing Address - Fax:
Practice Address - Street 1:1175 W GRAND BLVD # 100
Practice Address - Street 2:
Practice Address - City:CORONA
Practice Address - State:CA
Practice Address - Zip Code:92882-4354
Practice Address - Country:US
Practice Address - Phone:951-441-1114
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFC36652106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist