Provider Demographics
NPI:1508636291
Name:CAMARA, GERALDO
Entity Type:Individual
Prefix:
First Name:GERALDO
Middle Name:
Last Name:CAMARA
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2415 5TH ST
Mailing Address - Street 2:
Mailing Address - City:SANGER
Mailing Address - State:CA
Mailing Address - Zip Code:93657-2264
Mailing Address - Country:US
Mailing Address - Phone:559-770-0812
Mailing Address - Fax:
Practice Address - Street 1:2415 5TH ST
Practice Address - Street 2:
Practice Address - City:SANGER
Practice Address - State:CA
Practice Address - Zip Code:93657-2264
Practice Address - Country:US
Practice Address - Phone:559-770-0812
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-01-04
Last Update Date:2024-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)