Provider Demographics
NPI:1659545598
Name:CAMMON, DESSIE REE
Entity Type:Individual
Prefix:
First Name:DESSIE
Middle Name:REE
Last Name:CAMMON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:901 W CHERRY ST
Mailing Address - Street 2:
Mailing Address - City:COMPTON
Mailing Address - State:CA
Mailing Address - Zip Code:90222-3803
Mailing Address - Country:US
Mailing Address - Phone:310-632-4909
Mailing Address - Fax:
Practice Address - Street 1:3605 LONG BEACH BLVD
Practice Address - Street 2:
Practice Address - City:LONG BEACH
Practice Address - State:CA
Practice Address - Zip Code:90807-4013
Practice Address - Country:US
Practice Address - Phone:562-427-2006
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-04-22
Last Update Date:2008-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist