Provider Demographics
NPI:1699846865
Name:DEOCAMPO, JOSEPH (PHN)
Entity Type:Individual
Prefix:MR
First Name:JOSEPH
Middle Name:
Last Name:DEOCAMPO
Suffix:
Gender:M
Credentials:PHN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13729 MARQUITA LN
Mailing Address - Street 2:
Mailing Address - City:WHITTIER
Mailing Address - State:CA
Mailing Address - Zip Code:90604-4374
Mailing Address - Country:US
Mailing Address - Phone:714-896-7367
Mailing Address - Fax:714-896-7316
Practice Address - Street 1:14120 BEACH BLVD
Practice Address - Street 2:SUITE # 104
Practice Address - City:WESTMINSTER
Practice Address - State:CA
Practice Address - Zip Code:92683-4454
Practice Address - Country:US
Practice Address - Phone:714-896-7367
Practice Address - Fax:714-896-7316
Is Sole Proprietor?:No
Enumeration Date:2006-11-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CARN491665163WC1500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WC1500XNursing Service ProvidersRegistered NurseCommunity Health