Provider Demographics
NPI:1275885386
Name:CAMERON, HALLIE (LMFT)
Entity Type:Individual
Prefix:
First Name:HALLIE
Middle Name:
Last Name:CAMERON
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16 S OAKLAND AVE
Mailing Address - Street 2:SUITE 200
Mailing Address - City:PASADENA
Mailing Address - State:CA
Mailing Address - Zip Code:91101-2043
Mailing Address - Country:US
Mailing Address - Phone:818-497-0113
Mailing Address - Fax:
Practice Address - Street 1:4311 FINLEY AVE
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90027-2811
Practice Address - Country:US
Practice Address - Phone:818-538-5115
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-10-12
Last Update Date:2015-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALMFT86687106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist