Provider Demographics
NPI:1609041185
Name:CAMERON, RICHARD STEWART (MFT)
Entity Type:Individual
Prefix:MR
First Name:RICHARD
Middle Name:STEWART
Last Name:CAMERON
Suffix:
Gender:M
Credentials:MFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:205 E 3RD AVE
Mailing Address - Street 2:SUITE 203
Mailing Address - City:SAN MATEO
Mailing Address - State:CA
Mailing Address - Zip Code:94401-4051
Mailing Address - Country:US
Mailing Address - Phone:650-573-1956
Mailing Address - Fax:650-375-1961
Practice Address - Street 1:205 E 3RD AVE
Practice Address - Street 2:SUITE 203
Practice Address - City:SAN MATEO
Practice Address - State:CA
Practice Address - Zip Code:94401-4051
Practice Address - Country:US
Practice Address - Phone:650-573-1956
Practice Address - Fax:650-375-1961
Is Sole Proprietor?:Yes
Enumeration Date:2008-04-25
Last Update Date:2008-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMA20470101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health