Provider Demographics
NPI:1326491044
Name:CAMPBELL, CORRINA S
Entity Type:Individual
Prefix:
First Name:CORRINA
Middle Name:S
Last Name:CAMPBELL
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:CORY
Other - Middle Name:S
Other - Last Name:CAMPBELL
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:939 PALM AVE
Mailing Address - Street 2:
Mailing Address - City:CARPINTERIA
Mailing Address - State:CA
Mailing Address - Zip Code:93013-3548
Mailing Address - Country:US
Mailing Address - Phone:805-280-8882
Mailing Address - Fax:
Practice Address - Street 1:939 PALM AVE
Practice Address - Street 2:
Practice Address - City:CARPINTERIA
Practice Address - State:CA
Practice Address - Zip Code:93013-3548
Practice Address - Country:US
Practice Address - Phone:805-280-8882
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-07-18
Last Update Date:2016-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker