Provider Demographics
NPI:1417667890
Name:BORJA, CAMILA (CNM, WHNP)
Entity Type:Individual
Prefix:
First Name:CAMILA
Middle Name:
Last Name:BORJA
Suffix:
Gender:F
Credentials:CNM, WHNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2204 LAKESHORE AVE APT 5
Mailing Address - Street 2:
Mailing Address - City:OAKLAND
Mailing Address - State:CA
Mailing Address - Zip Code:94606-1017
Mailing Address - Country:US
Mailing Address - Phone:757-784-3196
Mailing Address - Fax:
Practice Address - Street 1:2180 MARKET ST
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94114-1319
Practice Address - Country:US
Practice Address - Phone:415-400-4938
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-11-28
Last Update Date:2022-11-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA236329176B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes176B00000XOther Service ProvidersMidwife
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA236329OtherMEDICAL BOARD
VA95231083OtherBOARD OF REGISTERED NURSES