Provider Demographics
NPI:1477828341
Name:CAMPOS, WENDY (LCSW85662)
Entity Type:Individual
Prefix:
First Name:WENDY
Middle Name:
Last Name:CAMPOS
Suffix:
Gender:F
Credentials:LCSW85662
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:27200 TOURNEY RD STE 410
Mailing Address - Street 2:
Mailing Address - City:SANTA CLARITA
Mailing Address - State:CA
Mailing Address - Zip Code:91355-4990
Mailing Address - Country:US
Mailing Address - Phone:661-705-4670
Mailing Address - Fax:661-964-3273
Practice Address - Street 1:27200 TOURNEY RD STE 410
Practice Address - Street 2:
Practice Address - City:SANTA CLARITA
Practice Address - State:CA
Practice Address - Zip Code:91355
Practice Address - Country:US
Practice Address - Phone:661-705-4670
Practice Address - Fax:661-964-3273
Is Sole Proprietor?:No
Enumeration Date:2012-03-12
Last Update Date:2018-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALCSW856621041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical